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

Abstract

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

Knowledge, Attitudes, and Beliefs Toward Organ Donation Registration Among Asian Americans: Development and Pilot-testing of Educational Intervention Video

“…4 Prior literature has suggested that the need for culturally competent interventions associated with opportunities for registration immediately after intervention could help improve the overall organ donation registration rates, but this remains a poorly understood area with few appropriate educational materials and interventions available. [4][5][6] This study attempts to bridge the gap by assessing the knowledge, attitudes, and beliefs toward organ donation as well as other factors affecting organ donation registration among Asian Americans in a large and diverse city and developing culturally competent educational material. We conducted surveys to identify factors associated with low organ donation registration among Asian Americans, developed an educational video informed by our findings, and then assessed the efficacy of this educational video to increase knowledge of organ donation to ultimately increase donor registrations among Asian Americans.…”

Knowledge and attitude regarding organ donation among medical students in Hong Kong: a cross-sectional study

“…The previous studies showed that healthcare professionals with positive attitudes towards organ donation are more likely to begin the organ donation process by seeking and obtaining consent from potential donor families 8. Recently, some reviews demonstrated that primary care interventions, for example, delivering organ donation information during practices and annual health check by trained general practitioners and staff, can significantly improve the organ donation registration rates,9 with more similar models were under trial 10 11. These indicated that doctors would play a more active role in organ donation promotion in the future, and they should be more prepared for it.…”