Limited evidence for the effectiveness of educational interventions for renal transplant recipients. Results from a systematic review of controlled clinical trials.

Abstract

OBJECTIVE: To describe the content and evaluate the effectiveness of patient education programs for renal recipients. METHODS: Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were identified through systematic literature searches in the Cochrane Central Register of Controlled Trials, Medline, Embase, CINAH, and ERIC. Reference lists and reviews were also examined. Methodological quality was evaluated according to criteria developed by the Cochrane Musculoskeletal Group. Interventional effects were summarized qualitatively. RESULTS: Nine trials were included, and three were RCT's. The educational interventions varied regarding focus, timing and intensity. No studies were assessed to have low risk of bias. Only two studies, which had a moderate risk of bias, reported beneficial effects in favor of the educational interventions. The strongest evidence was found for the use of preparatory video-assisted teaching prior to discharge and monthly pharmaceutical counseling. CONCLUSION: Few included studies with moderate to high risk of bias suggest limited evidence for the effects of educational interventions for renal recipients. PRACTICE IMPLICATIONS: Studies with stronger designs and improved reporting standards are needed. Future educational interventions should include a holistic educational approach and be provided in both early and later stages post transplantation. Furthermore, additional long-term outcome measures are needed.