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. 2021 Nov;34(11):2317-2328.
doi: 10.1111/tri.14011. Epub 2021 Sep 21.

Implementation of the kidney team at home intervention: Evaluating generalizability, implementation process, and effects

Steef Redeker  1 , Emma K Massey  2 , Charlotte Boonstra  3 , Jan J van Busschbach  1 , Reinier Timman  1 , Harald F H Brulez  4 , Daan A A M J Hollander  5 , Luuk B Hilbrands  6 , Frederike Bemelman  7 , Stefan P Berger  8 , Jacqueline van de Wetering  2 , René M A van den Dorpel  9 , Margriet Dekker-Jansen  10 , Willem Weimar  2 , Sohal Y Ismail  1 ; Kidney Team at Home consortium
Collaborators, Affiliations

Implementation of the kidney team at home intervention: Evaluating generalizability, implementation process, and effects

Steef Redeker et al. Transpl Int. 2021 Nov.

Abstract

Research has shown that a home-based educational intervention for patients with chronic kidney disease results in better knowledge and communication, and more living donor kidney transplantations (LDKT). Implementation research in the field of renal care is almost nonexistent. The aims of this study were (1) to demonstrate generalizability, (2) evaluate the implementation process, and (3) to assess the relationship of intervention effects on LDKT-activity. Eight hospitals participated in the project. Patients eligible for all kidney replacement therapies (KRT) were invited to participate. Effect outcomes were KRT-knowledge and KRT-communication, and treatment choice. Feasibility, fidelity, and intervention costs were assessed as part of the process evaluation. Three hundred and thirty-two patients completed the intervention. There was a significant increase in KRT-knowledge and KRT-communication among participants. One hundred and twenty-nine out of 332 patients (39%) had LDKT-activity, which was in line with the results of the clinical trials. Protocol adherence, knowledge, and age were correlated with LDKT-activity. This unique implementation study shows that the results in practice are comparable to the previous trials, and show that the intervention can be implemented, while maintaining quality. Results from the project resulted in the uptake of the intervention in standard care. We urge other countries to investigate the uptake of the intervention.

Keywords: family communication; home-based educational program; implementation; living kidney donation; patient education.

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Conflict of interest statement

All authors have no competing interests to report.

Figures

Figure 1
Figure 1
Flow‐chart of the Kidney Team at Home implementation project.
Figure 2
Figure 2
This graph depicts the cumulative hazard time‐to‐event data for the rate of LDKT‐activity. Covariates used were: age, postinterventional knowledge, postinterventional communication, gender, religion and ethnicity (Western/non‐Western).
See this image and copyright information in PMC

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