A multicomponent intervention designed to overcome barriers preventing patients with advanced chronic kidney disease (CKD) from receiving a kidney transplant did not significantly increase the rate of completed steps toward transplantation, according to a study published in Jama Internal Medicine. The study, conducted by researchers at the Regenstrief Institute, included all 26 CKD programs in Ontario, Canada, and involved a pragmatic, 2-arm, parallel-group, open-label, registry-based, cluster randomized clinical trial.
The intervention, which lasted for 4.2 years, included four main components: administrative support to establish local quality improvement teams, transplant educational resources, an initiative for transplant recipients and living donors to share stories and experiences, and program-level performance reports and oversight by administrative leaders. However, despite evidence of intervention uptake, the step completion rate did not significantly differ between the intervention and usual-care groups.
The findings suggest that improving access to transplantation remains a global priority that requires substantial effort. The study was supported by ICES, funded by an annual grant from the Ontario Ministry of Health and the Ministry of Long-Term Care. The authors of the study included researchers from various institutions, including McMaster University, the Lawson Health Research Institute, and the Regenstrief Institute.
