Primary Care Physicians' Attitudes and Practices Regarding Discussing Organ Donation With Their Patients

Center for Reducing Health Disparities, Division of Pulmonary and Critical Care, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio 44109, USA.
Journal of the National Medical Association (Impact Factor: 0.96). 02/2010; 102(1):52-8. DOI: 10.1016/S0027-9684(15)30478-8
Source: PubMed


Among the general population, discussing organ donation with a primary care provider may be associated with increased willingness to donate. However, the frequency with which primary care providers hold these discussions with their patients has not been reported.
Cross-sectional mail and an Internet survey of validated questions regarding organ donation were done.
A national sample of 831 primary care physicians. black, and Hispanic physicians were oversampled.
Few physicians reported receiving formal training in donation (17%). Only 5% of physicians have donor cards available in their practice, and only 11% have donation information available in their practice. While 30% of physicians reported discussing end-of-life care with their patients, fewer than 4% reported discussing donation with their patients. However, only 36% felt that discussing donation was outside of their scope of practice. In a multivariate regression model, predictors of discussing donation with patients included having received formal education about organ donation (odds ratio [OR], 2.6; p < .05) and discussing end-of-life care with patients (OR, 12.8; p < .001).
Very few primary care physicians reported discussing organ donation with their patients despite the majority agreeing that it was within their scope of practice. Primary care physicians who had received education on the subject or who regularly discuss end-of-life care with their patients were more likely to discuss donation. Efforts to improve donation in the general population should include a focus on understanding and improving communication about organ donation between providers and their patients.

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    • "In a recent U.S. study, very few primary care physicians reported having received appropriate training in medical school, with most of them rating their knowledge as limited (Thornton, Curtis, & Allen, 2010). Organ donation remains an extremely uncommon discussion topic, despite the fact that 30% of physicians discuss end-of-life issues with more than half of their patients (Thornton et al., 2010). More nurses, compared with physicians, expressed concerns about kidneys being removed after death and about the medical team's intention to preserve the life of a potential donor, reflecting their mistrust to the medical system. "
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    • "En otro estudio, Amaral et al. (2002) realizaron un sondeo a un amplio grupo de profesores de medicina de un hospital público universitario de Brasil (Hospital Guilherme Álvaro) y comprobaron que 44% no sabía diagnosticar la muerte encefálica y mitad no sabía adoptar las medidas necesarias para el mantenimiento de la persona fallecida. Más recientemente, en un estudio de ámbito nacional, Thornton, Curtis y Allen (2010) comprobaron que apenas 17% de los médicos internistas y de cabecera encuestados había recibido formación sobre donación. También Deulofeu et al. (en prensa) han obtenido evidencia del desconocimiento de algunos aspectos clave entre médicos de urgencias, emergencias y atención primaria, además de comprobar que apenas el 52,3%, el 60,3% y el 28,0%, respectivamente, se consideraron capaces de valorar a un fallecido como potencial donante. "
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