{"id":26329,"date":"2023-11-21T09:20:41","date_gmt":"2023-11-21T13:20:41","guid":{"rendered":"https:\/\/cdtrp.ca\/?p=26329"},"modified":"2023-11-21T09:20:41","modified_gmt":"2023-11-21T13:20:41","slug":"enakt-lkd-trial","status":"publish","type":"post","link":"https:\/\/cdtrp.ca\/en\/enakt-lkd-trial\/","title":{"rendered":"Study Spotlight: Testing an intervention to enhance kidney transplant access &#8211; The EnAKT LKD Trial"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-center\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-dropshadow imageframe-1 hover-type-none\" style=\"-webkit-box-shadow: 3px 3px 7px rgba(0,0,0,0.3);box-shadow: 3px 3px 7px rgba(0,0,0,0.3);\"><img decoding=\"async\" width=\"1024\" height=\"576\" title=\"EnAKT LKD Trial Spotlight\" src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight.png\" data-orig-src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-1024x576.png\" alt class=\"lazyload img-responsive wp-image-26335\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271600%27%20height%3D%27900%27%20viewBox%3D%270%200%201600%20900%27%3E%3Crect%20width%3D%271600%27%20height%3D%27900%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-200x113.png 200w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-400x225.png 400w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-600x338.png 600w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-800x450.png 800w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight-1200x675.png 1200w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight.png 1600w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 1024px) 100vw, (max-width: 640px) 100vw, 1200px\" \/><\/span><\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:20px;margin-bottom:20px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-1\"><h4 data-pm-slice=\"1 1 &#091;&#093;\"><strong>Study Spotlight: Testing an intervention to enhance kidney transplant access &#8211; The EnAKT LKD Trial<\/strong><\/h4>\n<p>The CDTRP is excited to highlight the important <strong>EnAKT LKD Trial<\/strong>, led by researchers and CDTRP members, Dr. Amit Garg and Dr. Kyla Naylor. This pragmatic cluster-randomized trial aims to improve patient access to kidney transplantation and living kidney donation. The <a href=\"https:\/\/transplantambassadors.ca\/\">Transplant Ambassador Program<\/a> also plays a crucial role in supporting patient partners into this initiative.<\/p>\n<p>Patients with advanced CKD have the best chance for a longer and healthier life if they receive a kidney transplant. A transplant also costs the healthcare system less- for every 100 kidney transplants, the healthcare system saves $20 million over five years, primarily from averted dialysis costs. However, due to several barriers, many eligible patients today will never receive a kidney transplant.<\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#e0dede;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-text fusion-text-2\"><h5><strong>The EnAKT LKD Trial<\/strong><\/h5>\n<p>To address this problem, a pragmatic cluster-randomized trial, the <strong>Effect of a Multi-Component Intervention to Improve Patient Access to Kidney Transplantation and Living Kidney Donation (EnAKT LKD) Trial<\/strong>, was designed and conducted by a broad group of stakeholders to determine if CKD program-wide use of a multicomponent intervention could help eligible patients complete key steps towards receiving a kidney transplant.<\/p>\n<p>The trial included 20,375 patients who received care in Ontario\u2019s 26 CKD programs. The trial period which began in November 2017 was 4.2 years. Unfortunately, the arrival of the COVID-19 pandemic negatively affected intervention delivery, as CKD programs faced staffing challenges and shifting priorities for at least a year.<\/p>\n<p>Acknowledging the complications brought by the pandemic, the trial team was unable to show the intervention increased access to kidney transplantation and living kidney donation, despite evidence of intervention uptake at the participating centres.<\/p>\n<\/div><div style=\"text-align:center;\"><a class=\"fusion-button button-flat fusion-button-default-size button-custom fusion-button-default button-1 fusion-button-default-span fusion-button-default-type\" style=\"--button_accent_color:#ffffff;--button_border_color:#ffffff;--button_accent_hover_color:#edf2f7;--button_border_hover_color:#ffffff;--button_gradient_top_color:#d93833;--button_gradient_bottom_color:#d93833;--button_gradient_top_color_hover:#d93833;--button_gradient_bottom_color_hover:#d93833;--button_text_transform:uppercase;\" target=\"_self\" href=\"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2811529#:~:text=Conclusions%20and%20Relevance%20This%20novel,priority%20that%20requires%20substantial%20effort\"><span class=\"fusion-button-text\">Read the article<\/span><\/a><\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:#2b4257;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-center\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-dropshadow imageframe-2 hover-type-none\" style=\"-webkit-box-shadow: 3px 3px 7px rgba(0,0,0,0.3);box-shadow: 3px 3px 7px rgba(0,0,0,0.3);\"><img decoding=\"async\" width=\"380\" height=\"425\" title=\"O1Q3M5_Garg_Amit\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27380%27%20height%3D%27425%27%20viewBox%3D%270%200%20380%20425%27%3E%3Crect%20width%3D%27380%27%20height%3D%27425%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/O1Q3M5_Garg_Amit.jpg\" alt class=\"lazyload img-responsive wp-image-26331\"\/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_2_3 2_3 fusion-flex-column fusion-flex-align-self-center\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><ul style=\"--awb-line-height:28.9px;--awb-icon-width:28.9px;--awb-icon-height:28.9px;--awb-icon-margin:11.9px;--awb-content-margin:40.8px;\" class=\"fusion-checklist fusion-checklist-1 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-quote-left fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p><span style=\"color: #ffffff;\">&#8220;While we were unable to show this intervention increased access to kidney transplantation and living kidney donation, we are not giving up. We and others are deeply committed to addressing this complex and important problem. After much introspection, several aspects of our approach still seem sensible, such as the tracking of key steps towards transplant. We are currently completing a process evaluation to optimize our future approach.&#8221;<\/span><\/p>\n<p><span style=\"color: #ffffff;\"><strong>Dr. Amit Garg,<\/strong> Nephrologist and Professor of Medicine, Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry.<\/span><\/p>\n<\/div><\/li><\/ul><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3\"><h5><strong>Study outcomes<\/strong><\/h5>\n<p>While the findings of the trial were not what the team had hoped for, the intervention did result in several beneficial outcomes and exhibited important strengths that could be used in future trials:<\/p>\n<\/div><ul style=\"--awb-iconcolor:#59aaad;--awb-line-height:28.9px;--awb-icon-width:28.9px;--awb-icon-height:28.9px;--awb-icon-margin:11.9px;--awb-content-margin:40.8px;\" class=\"fusion-checklist fusion-checklist-2 fusion-checklist-default type-icons\"><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-search fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>The trial emphasized the importance of CKD programs and transplant centres participating in a learning healthcare system. In other words, a culture shift where centre staff are committed to robust assessments of what they do.<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-search fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>The intervention was designed and implemented by diverse stakeholders, including administrators, healthcare staff, patients and nephrologists using new educational materials.<\/p>\n<\/div><\/li><li class=\"fusion-li-item\" style=\"\"><span class=\"icon-wrapper circle-no\"><i class=\"fusion-li-icon fa-search fas\" aria-hidden=\"true\"><\/i><\/span><div class=\"fusion-li-item-content\">\n<p>The extent of patient-partner involvement in the trial could pave the way for how we think about patient engagement in future trials. Patient partners played an integral role throughout the trial, including developing the research question, designing the intervention, and developing and leading a key component of the intervention, the <a href=\"https:\/\/transplantambassadors.ca\/\">Transplant Ambassador Program<\/a>.<\/p>\n<\/div><\/li><\/ul><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:10px;margin-bottom:10px;width:100%;\"><\/div><div class=\"fusion-text fusion-text-4\"><p>It is challenging to improve patient access to kidney transplantation in busy healthcare environments despite the urgent need for effective solutions.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":6,"featured_media":26335,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,75],"tags":[],"class_list":["post-26329","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","category-featured"],"_links":{"self":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/26329"}],"collection":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/comments?post=26329"}],"version-history":[{"count":6,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/26329\/revisions"}],"predecessor-version":[{"id":26370,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/26329\/revisions\/26370"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media\/26335"}],"wp:attachment":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media?parent=26329"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/categories?post=26329"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/tags?post=26329"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}