Psychosocial information sharing to improve equity in kidney transplant evaluation.

Abstract

Purpose of review: Increasing transplant access overall and particularly among historically underserved and marginalized patient groups is a shared goal nationwide. Patient challenges with psychosocial factors, such as social support and health literacy, are recognized as among the top reasons patients may not be referred, evaluated, or waitlisted, key steps along the pathway to transplantation. Yet referring providers' (e.g., dialysis clinics') and transplant centers' processes for measuring, communicating about, and addressing patients' psychosocial challenges are inconsistent, can emphasize measures more relevant to dialysis care than transplant care, and are highly susceptible to implicit bias.

Recent findings: In this article, we illuminate the opportunity to standardize the patient psychosocial information that dialysis clinics and other nephrology care providers share with the transplant center when referring a patient for transplant evaluation. We highlight potential benefits and trade-offs to this approach and describe how regional coalitions comprising patients, caregivers, and community members can support developing and implementing a standardized template for this purpose, as well as the objectives that the coalition's efforts should pursue to this end.

Summary: Standardized templates for psychosocial information sharing at referral represent a key opportunity to improve quality, efficiency, and equity in pretransplant care as well as transplant access outcomes broadly.