Patient- And Provider-Reported Information about Transplantation and Subsequent Waitlisting

Megan L. Salter, Babak Orandi, Mara Ann McAdams Demarco, Andrew Law, Lucy Ann Meoni, Bernard Jaar, Stephen M Sozio, Wen Hong Linda Kao, Rulan S. Parekh, Dorry Segev

Research output: Contribution to journalArticle

Abstract

Because informed consent requires discussion of alternative treatments, proper consent for dialysis should incorporate discussion about other renal replacement options including kidney transplantation (KT). Accordingly, dialysis providers are required to indicate KT provision of information (KTPI) on CMS Form-2728; however, provider-reported KTPI does not necessarily imply adequate provision of information. Furthermore, the effect of KTPI on pursuit of KT remains unclear. We compared provider-reported KTPI (Form-2728) with patient-reported KTPI (in-person survey of whether a nephrologist or dialysis staff had discussed KT) in a prospective ancillary study of 388 hemodialysis initiates. KTPI was reported by both patient and provider for 56.2% of participants, by provider only for 27.8%, by patient only for 8.3%, and by neither for 7.7%. Among participants with provider-reported KTPI, older age was associated with lack of patient-reported KTPI. Linkage with the Scientific Registry for Transplant Recipients showed that 20.9% of participants were subsequently listed for KT. Patient-reported KTPI was independently associated with a 2.95-fold (95% confidence interval [95% CI], 1.54 to 5.66; P=0.001) higher likelihood of KT listing, whereas provider-reported KTPI was not associated with listing (hazard ratio, 1.18; 95% CI, 0.60 to 2.32; P=0.62). Our findings suggest that patient perception of KTPI is more important for KT listing than provider-reported KTPI. Patient-reported and provider-reported KTPI should be collected for quality assessment in dialysis centers because factors associated with discordance between these metrics might inform interventions to improve this process.

Original languageEnglish (US)
Pages (from-to)2871-2877
Number of pages7
JournalJournal of the American Society of Nephrology
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2014

Fingerprint

Kidney Transplantation
Transplantation
Dialysis
Confidence Intervals
Informed Consent
Registries
Renal Dialysis
Prospective Studies
Kidney

ASJC Scopus subject areas

  • Nephrology

Cite this

Patient- And Provider-Reported Information about Transplantation and Subsequent Waitlisting. / Salter, Megan L.; Orandi, Babak; McAdams Demarco, Mara Ann; Law, Andrew; Meoni, Lucy Ann; Jaar, Bernard; Sozio, Stephen M; Kao, Wen Hong Linda; Parekh, Rulan S.; Segev, Dorry.

In: Journal of the American Society of Nephrology, Vol. 25, No. 12, 01.12.2014, p. 2871-2877.

Research output: Contribution to journalArticle

Salter, Megan L. ; Orandi, Babak ; McAdams Demarco, Mara Ann ; Law, Andrew ; Meoni, Lucy Ann ; Jaar, Bernard ; Sozio, Stephen M ; Kao, Wen Hong Linda ; Parekh, Rulan S. ; Segev, Dorry. / Patient- And Provider-Reported Information about Transplantation and Subsequent Waitlisting. In: Journal of the American Society of Nephrology. 2014 ; Vol. 25, No. 12. pp. 2871-2877.
@article{f9d52eb7ee674aa5b34459b1405ca9ee,
title = "Patient- And Provider-Reported Information about Transplantation and Subsequent Waitlisting",
abstract = "Because informed consent requires discussion of alternative treatments, proper consent for dialysis should incorporate discussion about other renal replacement options including kidney transplantation (KT). Accordingly, dialysis providers are required to indicate KT provision of information (KTPI) on CMS Form-2728; however, provider-reported KTPI does not necessarily imply adequate provision of information. Furthermore, the effect of KTPI on pursuit of KT remains unclear. We compared provider-reported KTPI (Form-2728) with patient-reported KTPI (in-person survey of whether a nephrologist or dialysis staff had discussed KT) in a prospective ancillary study of 388 hemodialysis initiates. KTPI was reported by both patient and provider for 56.2{\%} of participants, by provider only for 27.8{\%}, by patient only for 8.3{\%}, and by neither for 7.7{\%}. Among participants with provider-reported KTPI, older age was associated with lack of patient-reported KTPI. Linkage with the Scientific Registry for Transplant Recipients showed that 20.9{\%} of participants were subsequently listed for KT. Patient-reported KTPI was independently associated with a 2.95-fold (95{\%} confidence interval [95{\%} CI], 1.54 to 5.66; P=0.001) higher likelihood of KT listing, whereas provider-reported KTPI was not associated with listing (hazard ratio, 1.18; 95{\%} CI, 0.60 to 2.32; P=0.62). Our findings suggest that patient perception of KTPI is more important for KT listing than provider-reported KTPI. Patient-reported and provider-reported KTPI should be collected for quality assessment in dialysis centers because factors associated with discordance between these metrics might inform interventions to improve this process.",
author = "Salter, {Megan L.} and Babak Orandi and {McAdams Demarco}, {Mara Ann} and Andrew Law and Meoni, {Lucy Ann} and Bernard Jaar and Sozio, {Stephen M} and Kao, {Wen Hong Linda} and Parekh, {Rulan S.} and Dorry Segev",
year = "2014",
month = "12",
day = "1",
doi = "10.1681/ASN.2013121298",
language = "English (US)",
volume = "25",
pages = "2871--2877",
journal = "Journal of the American Society of Nephrology : JASN",
issn = "1046-6673",
publisher = "American Society of Nephrology",
number = "12",

}

TY - JOUR

T1 - Patient- And Provider-Reported Information about Transplantation and Subsequent Waitlisting

AU - Salter, Megan L.

AU - Orandi, Babak

AU - McAdams Demarco, Mara Ann

AU - Law, Andrew

AU - Meoni, Lucy Ann

AU - Jaar, Bernard

AU - Sozio, Stephen M

AU - Kao, Wen Hong Linda

AU - Parekh, Rulan S.

AU - Segev, Dorry

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Because informed consent requires discussion of alternative treatments, proper consent for dialysis should incorporate discussion about other renal replacement options including kidney transplantation (KT). Accordingly, dialysis providers are required to indicate KT provision of information (KTPI) on CMS Form-2728; however, provider-reported KTPI does not necessarily imply adequate provision of information. Furthermore, the effect of KTPI on pursuit of KT remains unclear. We compared provider-reported KTPI (Form-2728) with patient-reported KTPI (in-person survey of whether a nephrologist or dialysis staff had discussed KT) in a prospective ancillary study of 388 hemodialysis initiates. KTPI was reported by both patient and provider for 56.2% of participants, by provider only for 27.8%, by patient only for 8.3%, and by neither for 7.7%. Among participants with provider-reported KTPI, older age was associated with lack of patient-reported KTPI. Linkage with the Scientific Registry for Transplant Recipients showed that 20.9% of participants were subsequently listed for KT. Patient-reported KTPI was independently associated with a 2.95-fold (95% confidence interval [95% CI], 1.54 to 5.66; P=0.001) higher likelihood of KT listing, whereas provider-reported KTPI was not associated with listing (hazard ratio, 1.18; 95% CI, 0.60 to 2.32; P=0.62). Our findings suggest that patient perception of KTPI is more important for KT listing than provider-reported KTPI. Patient-reported and provider-reported KTPI should be collected for quality assessment in dialysis centers because factors associated with discordance between these metrics might inform interventions to improve this process.

AB - Because informed consent requires discussion of alternative treatments, proper consent for dialysis should incorporate discussion about other renal replacement options including kidney transplantation (KT). Accordingly, dialysis providers are required to indicate KT provision of information (KTPI) on CMS Form-2728; however, provider-reported KTPI does not necessarily imply adequate provision of information. Furthermore, the effect of KTPI on pursuit of KT remains unclear. We compared provider-reported KTPI (Form-2728) with patient-reported KTPI (in-person survey of whether a nephrologist or dialysis staff had discussed KT) in a prospective ancillary study of 388 hemodialysis initiates. KTPI was reported by both patient and provider for 56.2% of participants, by provider only for 27.8%, by patient only for 8.3%, and by neither for 7.7%. Among participants with provider-reported KTPI, older age was associated with lack of patient-reported KTPI. Linkage with the Scientific Registry for Transplant Recipients showed that 20.9% of participants were subsequently listed for KT. Patient-reported KTPI was independently associated with a 2.95-fold (95% confidence interval [95% CI], 1.54 to 5.66; P=0.001) higher likelihood of KT listing, whereas provider-reported KTPI was not associated with listing (hazard ratio, 1.18; 95% CI, 0.60 to 2.32; P=0.62). Our findings suggest that patient perception of KTPI is more important for KT listing than provider-reported KTPI. Patient-reported and provider-reported KTPI should be collected for quality assessment in dialysis centers because factors associated with discordance between these metrics might inform interventions to improve this process.

UR - http://www.scopus.com/inward/record.url?scp=84923886247&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923886247&partnerID=8YFLogxK

U2 - 10.1681/ASN.2013121298

DO - 10.1681/ASN.2013121298

M3 - Article

VL - 25

SP - 2871

EP - 2877

JO - Journal of the American Society of Nephrology : JASN

JF - Journal of the American Society of Nephrology : JASN

SN - 1046-6673

IS - 12

ER -