Project: Improving Access to Kidney Transplants
(IMPAKT)
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Project Code: CD94
Administering Organisation:
Menzies School of Health Research
Program Manager:
Arwen
Pratt - Chronic Conditions
Project Leader:
Dr Alan Cass
Director of Renal Services
The George Institute of Sydney
Team Members/Core Group?:
Dr Jeannie Devitt (Anthropology)
Ms Cilla Preece (AHW & Health Sciences Research)
Ms Kate Anderson (Psychology & PHD Student)
Contact:
acass@george.org.au
Partners Involved:
National Health and Medical Research Council (NHMRC)
CRC for Aboriginal Health
The George Institute for International Health
Menzies School of Health Research
Four major hospitals (Royal Prince Alfred, Royal Perth, Queen
Elizabeth, Princess Alexandria)
Four regional hospitals
18 local dialysis treatment centres
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Project Summary
The project was carried out from 2004 to 2008.
IMPAKT (Improving Access to Kidney Transplant)
comprised three discrete studies investigating the existing
disparity in access to kidney transplants between Indigenous and
non-Indigenous Australians. The project looked at how health
systems in different Australian States and Territories provide
transplant services to patients. It has documented the experiences
of Aboriginal
and Torres Strait Islander patients, examining in some detail
their access to and use of transplant services. The study includes
an in-depth exploration of patients’ and staff perceptions
and attitudes as well as their suggestions for improvements. The
IMPAKT team visited and worked in 26 locations across the Northern
Territory, SA, NSW, Queensland and WA, including urban centres,
large regional towns, small remote towns and Indigenous
communities.
Summary of Project Outcomes
Indigenous patients’ interest in transplant
- Indigenous patients are interested in transplant but unclear
about the process. They also wish to be better informed about their
treatment plans.
- Patient education is not sufficiently targeted to the cultural,
language and literacy needs of Indigenous people.
Clinical uncertainties
- Many key transplant decision-makers are uncertain about the
benefits of transplant for Indigenous patients.
- There is a widespread perception among health service providers
that Indigenous patients are less likely to fully carry out
treatment requirements (i.e. they are seen as less
‘compliant’).
Systemic issues
- Communication issues profoundly affect patient/provider
interactions at all levels in ways that disadvantage Indigenous
patients.
- Under-resourcing and systems deficits, especially in the
regional areas, reduce capacity to address the needs of Indigenous
patients
- Distance and remoteness are critical aspects of the context of
patient care.
Ongoing Work
Key findings from the research highlight that Aboriginal and
Torres Strait Islander patients are interested in transplants but
are unclear about the process and that patient education is not
sufficiently targeted to the cultural, language and literacy needs
of Indigenous people.
In order to transfer these research findings, the project team
from IMPAKT plan to work collaboratively with service providers to
develop an appropriate education package targeting Aboriginal and
Torres Strait Islander people and patients.
Download a copy of the:
Related Links:
More information on IMPAKT can be found at: http://www.thegeorgeinstitute.org/iih/index.cfm?8D96D689-CE91-3C9F-4282-A66FE4254FD8
Publications:
- Cass, A., Devitt, J., Preece, C., Cunningham, J. et
al. 2004, 'Barriers to access by Indigenous Australians to
kidney transplantation: The IMPAKT study',
Nephrology, vol. 9, S144–46.
- Cunningham, J., Cass, A. & Arnold, P. C. 2005,
'Bridging the treatment gap for Indigenous Australians',
MJA, vol. 182, no. 10, pp. 505–56.
- Cunningham, J., Cass, A., Anderson, K. et al. 2006,
'Australian nephrologists' attitudes towards living kidney
donation', Nephrol. Dial. Transplant., vol. 21, no. 5,
1178–83.
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