Promoting deceased organ and tissue donation registration in family physician waiting rooms (RegisterNow-1): a pragmatic stepped-wedge, cluster randomized controlled registry trial.

Cross-Sectional Studies Humans Physicians, Family Registries Tissue and Organ Procurement Waiting Rooms
Behaviour change techniques Cluster randomized trial Family physician offices Organ donation Organ registration Pragmatic trial Stepped-wedge trial

Journal

BMC medicine
ISSN: 1741-7015
Titre abrégé: BMC Med
Pays: England
ID NLM: 101190723

Informations de publication

Date de publication:
03 03 2022
Historique:
received: 09 08 2021
accepted: 18 01 2022
entrez: 3 3 2022
pubmed: 4 3 2022
medline: 24 3 2022
Statut: epublish

Résumé

The shortage of available organs for life-saving transplants persists worldwide. While a majority support donating their organs or tissue when they die, many have not registered their wish to do so. When registered, next of kin are much more likely to follow-through with the decision to donate. In many countries, most people visit their family physician office each year and this setting is a promising, yet underused, site where more people could register for deceased organ donation. Our primary aim was to evaluate the effectiveness of an intervention to promote organ donation registration in family physician's offices. We developed an intervention to address barriers and enablers to organ donation registration that involved physician office reception staff inviting patients to register on a tablet in the waiting room while they waited for their appointment. We conducted a cross-sectional stepped-wedge cluster randomized controlled registry trial to evaluate the intervention. We recruited six family physician offices in Canada. All offices began with usual care and then every two weeks, one office (randomly assigned) started the intervention until all offices delivered the intervention. The primary outcome was registration for deceased organ donation in the provincial organ registration registry, assessed within the 7 days of the physician visit. At the end of the trial, we also conducted interviews with clinic staff to assess any barriers and enablers to delivering the intervention. The trial involved 24,616 patient visits by 13,562 unique patients: 12,484 visits in the intervention period and 12,132 in the control period. There was no statistically significant difference in the percentage of patients registered for deceased organ donation in the intervention versus control period (48.0% vs 46.2%; absolute difference after accounting for the secular trend: 0.12%; 95% CI: - 2.30, 2.54; p=0.92). Interviews with clinic staff indicated location of the tablet within a waiting room, patient rapport, existing registration, confidence and motivation to deliver the intervention and competing priorities as barriers and enablers to delivery. Our intervention did not increase donor registration. Nonetheless, family physician offices may still remain a promising setting to develop and evaluate better interventions to increase organ donation registration. NCT03213171.

Sections du résumé

BACKGROUND
The shortage of available organs for life-saving transplants persists worldwide. While a majority support donating their organs or tissue when they die, many have not registered their wish to do so. When registered, next of kin are much more likely to follow-through with the decision to donate. In many countries, most people visit their family physician office each year and this setting is a promising, yet underused, site where more people could register for deceased organ donation. Our primary aim was to evaluate the effectiveness of an intervention to promote organ donation registration in family physician's offices.
METHODS
We developed an intervention to address barriers and enablers to organ donation registration that involved physician office reception staff inviting patients to register on a tablet in the waiting room while they waited for their appointment. We conducted a cross-sectional stepped-wedge cluster randomized controlled registry trial to evaluate the intervention. We recruited six family physician offices in Canada. All offices began with usual care and then every two weeks, one office (randomly assigned) started the intervention until all offices delivered the intervention. The primary outcome was registration for deceased organ donation in the provincial organ registration registry, assessed within the 7 days of the physician visit. At the end of the trial, we also conducted interviews with clinic staff to assess any barriers and enablers to delivering the intervention.
RESULTS
The trial involved 24,616 patient visits by 13,562 unique patients: 12,484 visits in the intervention period and 12,132 in the control period. There was no statistically significant difference in the percentage of patients registered for deceased organ donation in the intervention versus control period (48.0% vs 46.2%; absolute difference after accounting for the secular trend: 0.12%; 95% CI: - 2.30, 2.54; p=0.92). Interviews with clinic staff indicated location of the tablet within a waiting room, patient rapport, existing registration, confidence and motivation to deliver the intervention and competing priorities as barriers and enablers to delivery.
CONCLUSIONS
Our intervention did not increase donor registration. Nonetheless, family physician offices may still remain a promising setting to develop and evaluate better interventions to increase organ donation registration.
TRIAL REGISTRATION
NCT03213171.

Identifiants

DOI: 10.1186/s12916-022-02266-8 PMID: 35236353 PMC: PMC8892727
pubmed: 35236353
doi: 10.1186/s12916-022-02266-8
pii: 10.1186/s12916-022-02266-8
pmc: PMC8892727
doi:

Banques de données

ClinicalTrials.gov
['NCT03213171']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

75

Subventions

Organisme : CIHR
ID : CIHR-SCT-151609
Pays : Canada

Informations de copyright

© 2022. The Author(s).

Références

Transpl Int. 2012 Aug;25(8):801-11
pubmed: 22507140
Transplant Rev (Orlando). 2017 Oct;31(4):268-275
pubmed: 28951124
Stat Med. 2016 Nov 20;35(26):4718-4728
pubmed: 27350420
BMJ. 2015 Feb 06;350:h391
pubmed: 25662947
Qual Saf Health Care. 2005 Feb;14(1):26-33
pubmed: 15692000
Implement Sci. 2012 Apr 24;7:37
pubmed: 22530986
CMAJ Open. 2016 Oct 11;4(4):E551-E561
pubmed: 28443265
Trials. 2019 Jan 18;20(1):68
pubmed: 30658677
Prog Transplant. 2019 Sep;29(3):204-212
pubmed: 31232179
Trials. 2017 Dec 21;18(1):610
pubmed: 29268758
Clin Transplant. 2019 Mar;33(3):e13475
pubmed: 30614078
Ann Behav Med. 2013 Aug;46(1):81-95
pubmed: 23512568
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
Stat Med. 2016 Jun 15;35(13):2149-66
pubmed: 26748662
Biometrics. 1997 Sep;53(3):983-97
pubmed: 9333350
J Gen Intern Med. 2016 Aug;31(8):832-9
pubmed: 26921161
Br J Gen Pract. 2020 Jun 25;70(696):e497-e504
pubmed: 32366531

Auteurs

Alvin Ho-Ting Li (AH)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada. ali66@uwo.ca.
Lawson Health Research Institute, London, ON, Canada. ali66@uwo.ca.
Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada. ali66@uwo.ca.

Amit X Garg (AX)

Lawson Health Research Institute, London, ON, Canada.
Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Division of Nephrology, Western University, London, ON, Canada.

Jeremy M Grimshaw (JM)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Versha Prakash (V)

Trillium Gift of Life Network, Toronto, ON, Canada.

Alexie J Dunnett (AJ)

Lawson Health Research Institute, London, ON, Canada.

Stephanie N Dixon (SN)

Lawson Health Research Institute, London, ON, Canada.
Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Monica Taljaard (M)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.

Joanna Mitchell (J)

Citizen partner, London, ON, Canada.

Kyla L Naylor (KL)

Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada.
Department of Family Medicine, Western University, London, ON, Canada.

Cathy Faulds (C)

Department of Family Medicine, Western University, London, ON, Canada.

Rachel Bevan (R)

Department of Family Medicine, Western University, London, ON, Canada.

Leah Getchell (L)

Lawson Health Research Institute, London, ON, Canada.

Greg Knoll (G)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

S Joseph Kim (SJ)

University Health Network, University of Toronto, Toronto, ON, Canada.

Jessica Sontrop (J)

Lawson Health Research Institute, London, ON, Canada.
Institute for Clinical Evaluative Sciences (ICES) Western, London, ON, Canada.
Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Allison Tong (A)

Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.

Lise M Bjerre (LM)

School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.

Karyn Hyjek (K)

Trillium Gift of Life Network, Toronto, ON, Canada.

Donna Currie (D)

Citizen partner, London, ON, Canada.

Susan Edwards (S)

Citizen partner, London, ON, Canada.

Mike Sullivan (M)

Citizen partner, London, ON, Canada.

Linda Harvey-Rioux (L)

Citizen partner, London, ON, Canada.

Justin Presseau (J)

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
School of Psychology, University of Ottawa, Ottawa, ON, Canada.

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Promoting deceased organ and tissue donation...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Promoting deceased organ and tissue donation...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › Médecins › Médecins de famille › Promoting deceased organ and tissue donation...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Promoting deceased organ and tissue donation...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Acquisition d'organes et de tissus › Promoting deceased organ and tissue donation...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Salles d'attente › Promoting deceased organ and tissue donation...