{"id":26330,"date":"2023-11-21T09:24:42","date_gmt":"2023-11-21T13:24:42","guid":{"rendered":"https:\/\/cdtrp.ca\/?p=26330"},"modified":"2023-11-21T09:24:42","modified_gmt":"2023-11-21T13:24:42","slug":"essai-enakt-lkd","status":"publish","type":"post","link":"https:\/\/cdtrp.ca\/fr\/essai-enakt-lkd\/","title":{"rendered":"\u00c9tude en vedette : Test d&rsquo;une intervention visant \u00e0 am\u00e9liorer l&rsquo;acc\u00e8s aux greffes r\u00e9nales &#8211; L&rsquo;essai EnAKT LKD"},"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=\"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-orig-src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2023\/11\/EnAKT-LKD-Trial-Spotlight_FR.png\" alt class=\"lazyload img-responsive wp-image-26336\"\/><\/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>\u00c9tude en vedette : Test d&rsquo;une intervention visant \u00e0 am\u00e9liorer l&rsquo;acc\u00e8s aux greffes r\u00e9nales &#8211; L&rsquo;essai EnAKT LKD<\/strong><\/h4>\n<p>Le PRDTC est heureux de mettre en lumi\u00e8re l&rsquo;important <strong>essai EnAKT LKD<\/strong>, dirig\u00e9 par les chercheurs et membres du PRDTC, Dr Amit Garg et Dre Kyla Naylor. Cet essai pragmatique randomis\u00e9 en grappes vise \u00e0 am\u00e9liorer l&rsquo;acc\u00e8s des patients \u00e0 la transplantation r\u00e9nale et au don vivant de rein. Le <a href=\"https:\/\/transplantambassadors.ca\/\">Transplant Ambassador Program<\/a> joue \u00e9galement un r\u00f4le crucial dans le soutien des patients partenaires dans cette initiative.<\/p>\n<p>Les patients atteints d&rsquo;une maladie r\u00e9nale chronique avanc\u00e9e ont les meilleures chances de vivre plus longtemps et en meilleure sant\u00e9 s&rsquo;ils b\u00e9n\u00e9ficient d&rsquo;une greffe de rein. Une greffe co\u00fbte \u00e9galement moins cher au syst\u00e8me de sant\u00e9 : pour 100 greffes r\u00e9nale, le syst\u00e8me de sant\u00e9 \u00e9conomise 20 millions de dollars sur cinq ans, principalement gr\u00e2ce aux co\u00fbts de dialyse \u00e9vit\u00e9s. Cependant, en raison de plusieurs obstacles, de nombreux patients \u00e9ligibles aujourd&rsquo;hui ne recevront jamais de greffe de rein.<\/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>L&rsquo;essai EnAKT LKD<\/strong><\/h5>\n<p>Pour r\u00e9soudre ce probl\u00e8me, un essai pragmatique randomis\u00e9 en grappes, l&rsquo;<strong>essai EnAKT LKD<\/strong> (<em><strong>Effect of a Multi-Component Intervention to Improve Patient Access to Kidney Transplantation and Living Kidney Donation<\/strong><\/em>), a \u00e9t\u00e9 con\u00e7u et men\u00e9 par un large groupe de parties prenantes afin de d\u00e9terminer si l&rsquo;utilisation d&rsquo;une intervention \u00e0 plusieurs composantes \u00e0 l&rsquo;\u00e9chelle d&rsquo;un programme de maladies r\u00e9nales chroniques (CKD) pouvait aider les patients \u00e9ligibles \u00e0 franchir les \u00e9tapes cl\u00e9s pour recevoir une greffe de rein.<\/p>\n<p>L&rsquo;essai a inclus 20 375 patients qui ont re\u00e7u des soins dans les 26 programmes CKD de l&rsquo;Ontario. La p\u00e9riode d&rsquo;essai, qui a d\u00e9but\u00e9 en novembre 2017, \u00e9tait de 4,2 ans. Malheureusement, l&rsquo;arriv\u00e9e de la pand\u00e9mie de COVID-19 a eu un impact n\u00e9gatif sur la mise en \u0153uvre des interventions, car les programmes de CKD ont \u00e9t\u00e9 confront\u00e9s \u00e0 des probl\u00e8mes de personnel et \u00e0 des changements de priorit\u00e9s pendant au moins un an.<\/p>\n<p>Reconnaissant les complications li\u00e9es \u00e0 la pand\u00e9mie, l&rsquo;\u00e9quipe charg\u00e9e de l&rsquo;essai n&rsquo;a pas \u00e9t\u00e9 en mesure de d\u00e9montrer que l&rsquo;intervention augmentait l&rsquo;acc\u00e8s \u00e0 la transplantation r\u00e9nale et au don vivant de rein, malgr\u00e9 les preuves de l&rsquo;adoption de l&rsquo;intervention dans les centres participants.<\/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\">Lisez l&rsquo;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;\">\u00ab Bien que nous n&rsquo;ayons pas \u00e9t\u00e9 en mesure de d\u00e9montrer que cette intervention am\u00e9liorait l&rsquo;acc\u00e8s \u00e0 la transplantation r\u00e9nale et au don vivant de rein, nous ne baissons pas les bras. Nous sommes, avec d&rsquo;autres, profond\u00e9ment engag\u00e9s dans la r\u00e9solution de ce probl\u00e8me complexe et important. Apr\u00e8s une longue introspection, plusieurs aspects de notre approche semblent toujours judicieux, comme le suivi des \u00e9tapes cl\u00e9s vers la transplantation. Nous proc\u00e9dons actuellement \u00e0 une \u00e9valuation des processus afin d&rsquo;optimiser notre approche future. \u00bb<\/span><\/p>\n<p><span style=\"color: #ffffff;\"><strong>Dr Amit Garg,<\/strong> n\u00e9phrologue et professeur de m\u00e9decine, d&rsquo;\u00e9pid\u00e9miologie et de biostatistique \u00e0 la 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>R\u00e9sultats de l&rsquo;\u00e9tude<\/strong><\/h5>\n<p>Bien que les r\u00e9sultats de l&rsquo;essai n&rsquo;aient pas \u00e9t\u00e9 \u00e0 la hauteur des esp\u00e9rances de l&rsquo;\u00e9quipe, l&rsquo;intervention a permis d&rsquo;obtenir plusieurs r\u00e9sultats b\u00e9n\u00e9fiques et a montr\u00e9 des points forts importants qui pourraient \u00eatre utilis\u00e9s dans de futurs essais :<\/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>L&rsquo;essai a soulign\u00e9 l&rsquo;importance pour les programmes de CKD et les centres de transplantation de participer \u00e0 un syst\u00e8me de soins de sant\u00e9 en apprentissage. En d&rsquo;autres termes, il s&rsquo;agit d&rsquo;un changement de culture o\u00f9 le personnel du centre s&rsquo;engage \u00e0 \u00e9valuer rigoureusement ce qu&rsquo;il fait.<\/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>L&rsquo;intervention a \u00e9t\u00e9 con\u00e7ue et mise en \u0153uvre par diverses parties prenantes, notamment des administrateurs, du personnel soignant, des patients et des n\u00e9phrologues, \u00e0 l&rsquo;aide de nouveaux supports p\u00e9dagogiques.<\/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>L&rsquo;ampleur de l&rsquo;implication des patients partenaires dans l&rsquo;essai pourrait ouvrir la voie \u00e0 la fa\u00e7on dont nous envisageons l&rsquo;engagement des patients dans les essais futurs. Les patients partenaires ont jou\u00e9 un r\u00f4le essentiel tout au long de l&rsquo;essai, notamment en \u00e9laborant la question de recherche, en concevant l&rsquo;intervention et en \u00e9laborant et en dirigeant un \u00e9l\u00e9ment cl\u00e9 de l&rsquo;intervention, le <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>Il est difficile d&rsquo;am\u00e9liorer l&rsquo;acc\u00e8s des patients \u00e0 la transplantation r\u00e9nale dans des environnements de soins de sant\u00e9 tr\u00e8s charg\u00e9s, malgr\u00e9 le besoin urgent de solutions efficaces.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":6,"featured_media":26334,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[81,37],"tags":[],"class_list":["post-26330","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-en-vedette","category-non-classifiee"],"_links":{"self":[{"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/posts\/26330"}],"collection":[{"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/comments?post=26330"}],"version-history":[{"count":4,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/posts\/26330\/revisions"}],"predecessor-version":[{"id":26371,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/posts\/26330\/revisions\/26371"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/media\/26334"}],"wp:attachment":[{"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/media?parent=26330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/categories?post=26330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdtrp.ca\/fr\/wp-json\/wp\/v2\/tags?post=26330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}