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Pilot test of a patient decision aid about liver transplant organ quality
Author(s) -
Volk Michael L.,
Roney Meghan,
Fagerlin Angela
Publication year - 2014
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23882
Subject(s) - medicine , liver transplantation , liver disease , human immunodeficiency virus (hiv) , test (biology) , informed consent , intensive care medicine , transplantation , surgery , family medicine , pathology , alternative medicine , paleontology , biology
Prior studies have shown that patients are reluctant to accept donor‐specific risks, and transplant professionals lack an effective and time‐efficient means of obtaining informed consent. We designed and pilot‐tested a Web‐based patient decision aid (DA) on organ quality. The DA was administered to 53 liver transplant candidates (median Model for End‐Stage Liver Disease score = 14, range = 7‐26), and they took a mean of 15 minutes to complete it. Questions about knowledge and attitudes were asked before and after the DA. Subjects' knowledge improved, with 53% and 60% correctly answering questions about hepatitis B virus and human immunodeficiency virus transmission before the DA and 94% and 100%, respectively, correctly answering them afterward ( P < 0.001). The accuracy of mortality prediction also improved from a mean 3‐month mortality estimate of 22% before the DA to 12% afterward ( P < 0.001). After the DA, subjects felt that it was more likely that they might be offered a less‐than‐perfect liver ( P = 0.001), and they were more likely to consider accepting such a liver ( P < 0.001). In conclusion, implementing a Web‐based patient DA is feasible and improves knowledge among liver transplant candidates. The use of this tool may decrease candidates' reluctance to accept extended criteria organs. Liver Transpl 20:850‐855, 2014 . © 2014 AASLD.