Technological Innovations for Live Kidney Donor Follow-up Care Management

活体肾脏捐赠者后续护理管理的技术创新

• 批准号: 10212371
• 负责人: Macey Leigh Levan
• 金额: --
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2022-02-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10212371
• 关键词: Address; Adoption; Altruism; Attitude; Behavior; Benchmarking; Car Phone; Caring; Chronic Kidney Failure; Clinical; Communication; Communities; Creatinine; Data; Detection; Development; Diabetes Mellitus; Dialysis procedure; Doctor of Philosophy; Early Diagnosis; Early Intervention; Education; Electronic Mail; Elements; End stage renal failure; Failure; Focus Groups; Foundations; Funding; Future; Glomerulonephritis; Goals; Health Policy; Health Promotion; Health Technology; Health system; Hematuria; Hyperglycemia; Hypertension; Individual; Intervention; Intervention Trial; Interview; Kidney; Kidney Diseases; Kidney Transplantation; Knowledge; Laboratories; Lead; Maintenance; Medical; Mentored Research Scientist Development Award; Nephrectomy; Operative Surgical Procedures; Outcome; Ownership; Participant; Patients; Perception; Pilot Projects; Policies; Prevention strategy; Proteins; Proteinuria; Provider; Qualitative Methods; Randomized; Randomized Controlled Trials; Research; Research Design; Risk; Serum; Surveys; System; Technology; Testing; Text; Time; Training; Transplantation; Urine; Work; base; career; comorbidity; control trial; cost; design; epidemiology study; experience; faculty research; follow-up; improved; informant; innovation; living kidney donor; mHealth; medical schools; novel; patient engagement; patient oriented; patient oriented research; preference; recruit; risk minimization; satisfaction; technological innovation; therapy development; tool; transplant centers

Project Summary Dr. Macey L. Henderson, JD, PhD, is research faculty in the Department of Surgery at Johns Hopkins School of Medicine. She seeks a Mentored Research Scientist Development Award in order to gain training and experience in patient-oriented research, qualitative methods, mHealth intervention development, and RCT design. Live donor kidney transplantation (KT) offers patients with end-stage renal disease (ESRD) timely treatment with superior outcomes to dialysis or deceased donor KT. But for the 6000+ live kidney donors (LKDs) yearly who make the sacrifice, and the 100,000+ living with one kidney, nephrectomy represents an elevated risk of kidney disease and other comorbidities. Dr. Henderson is a previous kidney donor and has dedicated her career to improving the lifelong donor experience. Currently, the most striking gap in the care of LKDs is the lack of regular medical follow-up. While hardly adequate for true care of LKDs (policy only requires follow-up to 24 months), implementation of even this rudimentary requirement has proven nearly impossible: LKDs between 2013-2015 still have only 68%, 62%, and 53% successful follow-up at 6, 12, and 24 months, with no further improvement since the policy requirement, even in the face of disciplinary action to centers who do not meet follow-up benchmarks: clearly transplant centers currently lack the tools to improve LKD engagement. Given the embarrassing failure of the current system of LKD follow-up, alternative approaches are of the utmost urgency for the medical community to uphold its obligation to care for these altruistic, at-risk individuals. Follow-up barriers cited by transplant centers, including administrative burden, cost, and lack of patient engagement, may be overcome by leveraging electronic communications and mobile health (mHealth) technologies which are convenient, low cost, and easily scalable. The aims of the project are: 1) to analyze preferences for and barriers to adoption of mHealth by LKDs and transplant providers, 2) to develop a functional mHealth system to support LKD follow-up and engagement, and 3) to pilot the mHealth system and design a future randomized control trial of this intervention. This proposal gives Dr. Henderson the training required to complete the proposed research. This knowledge can support the development of patient-oriented ESRD prevention strategies, promote health maintenance behaviors, and lay the foundation for a randomized controlled trial of our novel mHealth system. Our findings will address a critical knowledge gap in how follow-up and patient-engagement for LKDs can be improved. Conducting this study will expand Dr. Henderson's skillset to include patient-oriented research, qualitative methods, mHealth intervention development, and RCT design enabling her transition to independence.

项目概要 Macey L. Henderson 博士，法学博士，哲学博士，约翰霍普金斯大学外科系研究员 医学。她寻求指导研究科学家发展奖以获得培训和 在以患者为中心的研究、定性方法、移动医疗干预开发和随机对照试验方面拥有丰富的经验 设计。活体肾移植（KT）为终末期肾病（ESRD）患者提供及时的帮助 治疗效果优于透析或已故捐赠者 KT。但对于6000+活体肾捐献者来说 （LKD）每年做出牺牲，超过 100,000 人生活在一个肾脏中，肾切除术代表了一种 肾脏疾病和其他合并症的风险增加。亨德森博士曾是一名肾脏捐赠者，并拥有 她的职业生涯致力于改善终身捐赠者的体验。目前，最显着的差距是在护理方面 LKD 是缺乏定期医疗随访。虽然不足以真正照顾 LKD（政策只要求 后续 24 个月），即使是这个基本要求的实施也被证明几乎是不可能的： 2013-2015 年间的 LKD 在 6、12 和 24 个月时的随访成功率仍然只有 68%、62% 和 53%， 自政策要求以来，即使面临对中心的纪律处分，也没有进一步的改善 不符合后续基准：显然移植中心目前缺乏改善 LKD 的工具 订婚。鉴于当前 LKD 后续系统的尴尬失败，替代方法 对于医学界来说，履行照顾这些无私的高危人群的义务至关重要 个人。移植中心提到的后续障碍，包括行政负担、成本和缺乏 患者参与度可以通过利用电子通信和移动医疗（mHealth）来克服 技术方便、成本低且易于扩展。 该项目的目标是： 1) 分析 LKD 和企业采用移动医疗的偏好和障碍 移植提供者，2) 开发功能性移动医疗系统以支持 LKD 随访和参与， 3) 试点移动医疗系统并设计该干预措施的未来随机对照试验。 该提案为亨德森博士提供了完成拟议研究所需的培训。这些知识 可以支持制定以患者为导向的 ESRD 预防策略，促进健康维护 行为，并为我们的新型移动医疗系统的随机对照试验奠定基础。我们的发现 将解决如何改善 LKD 的随访和患者参与方面的关键知识差距。 进行这项研究将扩展亨德森博士的技能，包括以患者为导向的研究、定性研究、 方法、移动医疗干预开发和随机对照试验设计使她能够过渡到独立。