Skip to main content
Duke University Libraries
DukeSpace Scholarship by Duke Authors
  • Login
  • Ask
  • Menu
  • Login
  • Ask a Librarian
  • Search & Find
  • Using the Library
  • Research Support
  • Course Support
  • Libraries
  • About
View Item 
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
  •   DukeSpace
  • Duke Scholarly Works
  • Scholarly Articles
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Role of patient factors, preferences, and distrust in health care and access to liver transplantation and organ donation.

Thumbnail
View / Download
168.0 Kb
Date
2016-07
Authors
Wilder, Julius M
Oloruntoba, Omobonike O
Muir, Andrew J
Moylan, Cynthia A
Repository Usage Stats
149
views
297
downloads
Abstract
Despite major improvements in access to liver transplantation (LT), disparities remain. Little is known about how distrust in medical care, patient preferences, and the origins shaping those preferences contribute to differences surrounding access. We performed a single-center, cross-sectional survey of adults with end-stage liver disease and compared responses between LT listed and nonlisted patients as well as by race. Questionnaires were administered to 109 patients (72 nonlisted; 37 listed) to assess demographics, health care system distrust (HCSD), religiosity, and factors influencing LT and organ donation (OD). We found that neither HCSD nor religiosity explained differences in access to LT in our population. Listed patients attained higher education levels and were more likely to be insured privately. This was also the case for white versus black patients. All patients reported wanting LT if recommended. However, nonlisted patients were significantly less likely to have discussed LT with their physician or to be referred to a transplant center. They were also much less likely to understand the process of LT. Fewer blacks were referred (44.4% versus 69.7%; P = 0.03) or went to the transplant center if referred (44.4% versus 71.1%; P = 0.02). Fewer black patients felt that minorities had as equal access to LT as whites (29.6% versus 57.3%; P < 0.001). For OD, there were more significant differences in preferences by race than listing status. More whites indicated OD status on their driver's license, and more blacks were likely to become an organ donor if approached by someone of the same cultural or ethnic background (P < 0.01). In conclusion, our analysis demonstrates persistent barriers to LT and OD. With improved patient and provider education and communication, many of these disparities could be successfully overcome. Liver Transplantation 22 895-905 2016 AASLD.
Type
Journal article
Permalink
https://hdl.handle.net/10161/12749
Published Version (Please cite this version)
10.1002/lt.24452
Publication Info
Wilder, Julius M; Oloruntoba, Omobonike O; Muir, Andrew J; & Moylan, Cynthia A (2016). Role of patient factors, preferences, and distrust in health care and access to liver transplantation and organ donation. Liver Transpl, 22(7). pp. 895-905. 10.1002/lt.24452. Retrieved from https://hdl.handle.net/10161/12749.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
  • Scholarly Articles
More Info
Show full item record

Scholars@Duke

Moylan

Cynthia Ann Moylan

Associate Professor of Medicine
My research interests focus on the study of chronic liver disease and primary liver cancer, particularly from nonalcoholic fatty liver disease (NAFLD).  As part of the NAFLD Research Team at Duke, I am investigating the role of epigenetics and genetics on the development of advanced fibrosis from NAFLD.  The long term goal of our research is to develop non-invasive biomarkers to identify those patients at increased risk for cirrhosis and end stage liver disease in order to risk stratif
Muir

Andrew Joseph Muir

Professor of Medicine
Hepatitis C  Primary sclerosing cholangitis Cirrhosis Liver Transplantation Clinical Trials Healthcare disparities in liver disease  Outcomes Research
Oloruntoba

Omobonike Oyindasola Oloruntoba

Assistant Professor of Medicine
Wilder

Julius Middleton Wilder

Assistant Professor of Medicine
Alphabetical list of authors with Scholars@Duke profiles.
Open Access

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

Rights for Collection: Scholarly Articles


Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info

Make Your Work Available Here

How to Deposit

Browse

All of DukeSpaceCommunities & CollectionsAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit DateThis CollectionAuthorsTitlesTypesBy Issue DateDepartmentsAffiliations of Duke Author(s)SubjectsBy Submit Date

My Account

LoginRegister

Statistics

View Usage Statistics
Duke University Libraries

Contact Us

411 Chapel Drive
Durham, NC 27708
(919) 660-5870
Perkins Library Service Desk

Digital Repositories at Duke

  • Report a problem with the repositories
  • About digital repositories at Duke
  • Accessibility Policy
  • Deaccession and DMCA Takedown Policy

TwitterFacebookYouTubeFlickrInstagramBlogs

Sign Up for Our Newsletter
  • Re-use & Attribution / Privacy
  • Harmful Language Statement
  • Support the Libraries
Duke University