a prospective study to report the impact of consent on cornea retrieval
DESCRIPTION
A prospective study to report the impact of consent on Cornea Retrieval. Brinda P Ramachandran 1 Virender Sangwan 2 Usha Gopinathan 1 Ramayamma International Eye Bank L V Prasad Eye Institute, Hyderabad. Conflict of Interest Financial Disclosure NONE. Introduction - PowerPoint PPT PresentationTRANSCRIPT
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A prospective study to report the impact of consent on Cornea
RetrievalBrinda P Ramachandran1 Virender Sangwan2 Usha Gopinathan1
Ramayamma International Eye Bank L V Prasad Eye Institute, Hyderabad
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Conflict of Interest
Financial Disclosure
NONE
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Introduction
M Muraine et al in their study noted that: i. Asking the family of a dead patient to consider eye
donation is one of the most difficult aspects of the donation process.
ii. Health care professionals lack confidence & motivation to approach families to request for donation.
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Introduction
A study by Greg A Diamond concluded that
i. there must be a system for ensuring that families are asked for donation.
ii. A designated person be notified at the time of death to determine suitability for donation and then contact the family for donation.
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Objective
The purpose of this study was to understand who among the family members of a potential donor is ideal to be approached for counseling for eye donation
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Methodology
i. Study duration : 6 months ii. 5 multispecialty Hospitals in which Hospital
Cornea Retrieval Programme is conducted iii. A pre designed questionnaire to collect
demographic information of the donor & the next of kin
iv. Questionnaire filled by Eye Donation Counselorsv. Questionnaire was filled for every approach
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Methodology
Role of an Eye Donation Counselor
• Daily monitoring of the donation process• Counseling the donor families for eye donation• Providing frequent hospital staff education sessions• Providing family support• Maintaining close relationship with the Hospital
Administration
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Counseling the Donor family
•
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Methodology
Deciding to approach - Identifying the Decision maker/Influencer
Timing of approach
Steps in counseling• Introduction• Facts about eye donation• Objection handling• Closing & Withdrawal
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Data Analysis
SPSS ver 17.0 software for windows
- Univariable analysis – Chi Square test- Multivariable logistic regression analysis
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Results- 415 NoK were approached- 306 consented for eye donation
Consent rate of 73%
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Results
Age of donor (yrs)Odds Ratio P value
0 – 20 0.54 0.182 21 – 40 0.52 0.046 41 – 60 0.42 0.006 >60 1.00
Age of Donor was significantly associated with consent
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Results
Age of next of Kin (yrs) Odds Ratio P value
0 – 20 21 – 40 3.08 (1.21,7.86) 0.019 41 – 60 3.03 (1.17,7.78) 0.022 >60 1.00
Age of Nok was significantly associated with consent
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ResultsGender (Next of Kin)
Odds Ratio P value
Male 315 1.17(0.65,2.12) 0.602 Female 70 1.00
Gender of NoK – not significantly associated
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Consent by Relationship of NoK
success/request (%)
Parents 49/65 75Children 139/184 75Siblings 40/61 65Spouse 43/64 67Others 35/42 83
The relationship of the donor has not played any role with regard to consent for eye donation
Results
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Discussion
Our study shows an overall increasing trend towards consent with an increase in the age of the deceased similar to that observed by M Lawlor et al.
Our results also show that gender of NoK has no influence on the consent as found in other studies.
A higher proportion (OR 3.08 95% CI) of consent was obtained from NoK less than 60yrs of age
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Discussion
• The relationship of the NoK to the deceased has no influence on consent. Identifying the right family member to ask for donation increases the consent rate.
• It appeared that a designated person with systematic training, & a defined skill set including knowledge of eye donation and day to day experience in performing requests increases the consent rate.
• RIEB consent rates are some of the best in the world, with top performing eye banks across the world averaging around 73%.
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Conclusion
• There is a greater need to educate younger generation about eye donation so as to enable them to act as motivators for enhancing eye donation rates.
• The presence of a trained Eye Donation Counselor enhances the rate of consent thus increasing the donor numbers.
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Acknowledgement
- Donor Families - Hyderabad Eye Institute (HEI)
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L V Prasad Eye Institutewww.lvpei.org
Thank you!
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