Gibbons, Andrea, Cinnirella, Marco, Bayfield, Janet, Wu, Diana, Draper, Heather, Johnson, Rachel J., Tomson, Charles R. V., Forsythe, John L. R., Metcalfe, Wendy, Fogarty, Damian, Roderick, Paul, Ravanan, Rommel, Oniscu, Gabriel C., Watson, Christopher J. E., Bradley, J Andrew and Bradley, Clare (2017) Patient preferences, knowledge, and beliefs about kidney allocation : qualitative findings from the UK-wide ATTOM programme. BMJ Open . e013896. ISSN 2044-6055.

Preview

PDF WRAP_e013896.full.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1277Kb) | Preview

Request Changes to record.

Abstract

Objective: To explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys in the future.

Design: Qualitative study using semistructured interviews and thematic analysis based on a pragmatic approach.

Participants: 10 deceased-donor kidney transplant recipients, 10 live-donor kidney transplant recipients, 12 participants currently wait-listed for a kidney transplant and 4 participants whose kidney transplant failed.

Setting: Semistructured telephone interviews conducted with participants in their own homes across the UK.

Results: Three main themes were identified: uncertainty of knowledge of the allocation scheme; evaluation of the system and participant suggestions for future allocation schemes. Most participants identified human leucocyte anitgen matching as a factor in determining kidney allocation, but were often uncertain of the accuracy of their knowledge. In the absence of information that would allow a full assessment, the majority of participants consider that the current system is effective. A minority of participants were concerned about the perceived lack of transparency of the general decision-making processes within the scheme. Most participants felt that people who are younger and those better matched to the donor kidney should be prioritised for kidney allocation, but in contrast to the current scheme, less priority was considered appropriate for longer waiting patients. Some non-medical themes were also discussed, such as whether parents of dependent children should be prioritised for allocation, and whether patients with substance abuse problems be deprioritised.

Conclusions: Our participants held differing views about the most important factors for kidney allocation, some of which were in contrast to the current scheme. Patient participation in reviewing future allocation policies will provide insight as to what is considered acceptable to patients and inform healthcare staff of the kinds of information patients would find most useful.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Kidneys -- Transplantation -- Patients -- Attitudes, Kidneys -- Transplantation -- Waiting lists
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	January 2017
Dates:	Date Event January 2017 Published 27 January 2017 Available 5 January 2017 Accepted 15 August 2016 Submitted
Article Number:	e013896
Status:	Peer Reviewed
Publication Status:	Published
Date of first compliant deposit:	15 February 2017
Date of first compliant Open Access:	15 February 2017
Funder:	National Institute for Health Research (Great Britain) (NIHR)
Grant number:	RP-PG-0109-10116

Request changes or add full text files to a record

Repository staff actions (login required)

View Item

Downloads