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System Interventions to Achieve Early and Equitable Transplants (STEPS) Study

Not Applicable
Active, not recruiting
Conditions
Chronic Kidney Diseases
Interventions
Behavioral: STEPS Health System Outreach intervention
Registration Number
NCT05014256
Lead Sponsor
Wake Forest University Health Sciences
Brief Summary

This project will study how kidney care for everyone despite race can reduce racial differences in care and improve access to kidney transplants, and specifically living donor kidney transplants (LDKT), for individuals with chronic kidney disease. A study focused on equality and patient needs (called 'STEPS') will 1) create a program to identify people who may need a kidney transplant ('STEPS Surveillance') and find people in health systems who may be able to receive kidney transplants early in their care and (2) study how well the 'STEPS Outreach' program works (comprised of transplant social workers and transplant coordinators who focus on equality and patient needs) compared to usual care to improve access to kidney transplants among Black and non-Black individuals as well as to improve access to transplants for everyone.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
1168
Inclusion Criteria
  • Ability to provide oral informed consent
  • Male or female, aged 18 to <=75 years
  • Presence of CKD (2 eGFRs <60, 90 days apart) and at least 1 of the following: most recent eGFR less than 30 or KFRE greater than 10%
  • English speaking with adequate ability to hear and understand questions over the phone
  • Willing to comply with all study procedures and be available for the duration of the study
Exclusion Criteria
  • Male or female, aged <18 or > 75 years
  • Non-English speaking
  • Lack of ability to hear and comprehend verbal communication.
  • Patients on dialysis
  • Deceased
  • Hospice/palliative care
  • Prior kidney transplant
  • Currently waitlisted at any transplant center
  • Self-reported terminal illness or receipt of hospice services

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
STEPS Health System Surveillance and Outreach interventionSTEPS Health System Outreach intervention-
Primary Outcome Measures
NameTimeMethod
Health system reported completion of transplant evaluation18 months

Number of patients that said "yes" to the completion of transplant evaluation as reported in health system EHR and Administrative reports

Secondary Outcome Measures
NameTimeMethod
Patient reported initiation of transplant evaluation18 months

Number of patients that said "yes" to the initiation of transplant evaluation measured by patient report in questionnaire

Patient reported identification of a living donor18 months

Number of patients that said "yes" to the identification of a living donor measured by patient report in questionnaire

Placement on deceased kidney donor waitlist18 months

The number of patients that have been placed on the deceased kidney donor waitlist as reported in the EHR or UNOS

Patient reported kidney transplant knowledge18 months

Number of questions patients correctly answer measured by patient report in questionnaire

Live donor inquires to transplant center18 months

the number of participants that made an inquiry to the transplant center related to live donors as reported in EHR or from questionnaire

Deceased kidney donor transplants18 months

The number of patients that received a deceased kidney donor transplant as reported in EHR or USRDS

Patient reported family discussions18 months

number of times patient talked to family regarding kidney transplant measured by patient reported in questionnaire

Patient reported empowerment18 months

Calculation of scaled questions from the adapted DES-SF form using a range of 1-5 for each question, with 5 being the best outcome, measured by patient report in questionnaire.

Live kidney donor transplants18 months

The number of participants that completed their live kidney donor transplant as reported by the EHR or questionnaire

Health system reported initiation of transplant evaluation18 months

Number of patients that said "yes" to the initiation of transplant evaluation as reported in health system EHR and Administrative reports

Patient reported physician discussions18 months

number of times patient talked to physician regarding kidney transplant measured by patient report in questionnaire

Patient reported completion of transplant evaluation18 months

Number of patients that said "yes" to the completion of transplant evaluation measured by patient report in questionnaire

Trial Locations

Locations (1)

Wake Forest University Health Sciences

🇺🇸

Winston-Salem, North Carolina, United States

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