Family Physicians' Perspectives on Providing Living Kidney Donor Care.

RATIONALE &

OBJECTIVE

Living kidney donors (LKDs) perceive gaps in care along their donation journeys, such as poor coordination and communication between providers. Better integration of their primary care providers (PCPs) in their donation journey can help address these gaps. We captured the perspectives of Canadian PCPs to understand the challenges they perceive when caring for LKDs and their recommendations to address them.

STUDY

DESIGN

Qualitative descriptive design.

SETTING &

PARTICIPANTS

Semistructured in-depth interviews with 19 family physicians conducted until data saturation.

ANALYTICAL APPROACH: Thematic analysis.

RESULTS

Participants highlighted several challenges with the current living kidney donation processes: (1) limited scope of LKD care in primary practice; (2) poor clarity surrounding roles and responsibilities before donation (perceived as a facilitator) and after donation (perceived as low-barrier and high-access resource, and providing soft psychosocial support); (3) variable understanding of the living kidney donation process; and 4) lack of support and resources (patient accessibility to primary care, communication challenges between providers, poor health record transmission, limited availability of mental health services, limited financial support for patients and providers). The participants had 3 key recommendations: (1) support PCPs with pragmatic approaches and on-demand resources; (2) empower LKDs to be active participants in their care; and (3) implement strategies to address LKD care provision deficiencies (primary care accessibility, developing a collaborative care model, improving communication between all stakeholders, dedicated and prolonged psychosocial support, and governmental prioritization).

LIMITATIONS: About half the sample had limited experience with LKD care; inability to recruit some PCPs such as nurse practitioners.

CONCLUSIONS

As co-providers of patient care during the predonation phase and the primary drivers of care in the postdonation period, PCPs are positioned to deliver high-quality care to LKDs, contribute to long-term data collection, and potentially improve LKD outcomes. This study outlines challenges PCPs perceive and possible approaches to address them.

PLAIN-LANGUAGE SUMMARY: Living kidney donors (LKDs) have reported gaps in their care, such as poor communication and a lack of coordination between doctors. Because family physicians play a key role in supporting donors before and after surgery, we interviewed 19 Canadian family doctors to hear their perspectives. Participants reported challenges such as unclear roles, limited scope of seeing LKDs in their practices, poor communication with transplant centers, and a lack of mental health and financial services. They suggested multiple ways to improve LKD care, such as giving family doctors better resources, empowering LKDs to be active partners in their care, and several other systems-level approaches. These findings suggest that greater connections among primary care providers may improve donor well-being and outcomes.