Hybrid Telemedicine and In-Person Care for Kidney Transplant Follow-Up: A Qualitative Study

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2025-02-13 DOI:10.1111/ctr.70106

Suad Esayed, Ellie Kim, Hannah C. Sung, Abdula Al-Seraji, Simeon Adeyemo, Hayden Troutt, Ekamol Tantisattamoa, Antoney Ferrey, Uttam G. Reddy, Fatima T. Malik, Robert R. Redfield III, Hirohito Ichii, Abimereki D. Muzaale, Divyanshu Malhotra, Fawaz Al Ammary

{"title":"Hybrid Telemedicine and In-Person Care for Kidney Transplant Follow-Up: A Qualitative Study","authors":"Suad Esayed, Ellie Kim, Hannah C. Sung, Abdula Al-Seraji, Simeon Adeyemo, Hayden Troutt, Ekamol Tantisattamoa, Antoney Ferrey, Uttam G. Reddy, Fatima T. Malik, Robert R. Redfield III, Hirohito Ichii, Abimereki D. Muzaale, Divyanshu Malhotra, Fawaz Al Ammary","doi":"10.1111/ctr.70106","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Kidney transplant recipients are immunocompromised and require lifelong follow-up. Recipients face geographic, socioeconomic, and logistical challenges when seeking follow-up that can be alleviated using telemedicine. We aimed to understand patient experiences and preferences regarding telemedicine video visits and highlight insights to advance adopting hybrid telemedicine/in-person transplant care.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We conducted qualitative in-depth, semi-structured interviews with kidney transplant recipients between November 18, 2022, and January 11, 2023. Participants had follow-up at ≥12 months post-transplant via telemedicine at a tertiary transplant center. Study enrollment continued until data saturation was reached (<i>n</i> = 20 participants) when no new information emerged from additional interviews. Transcripts were analyzed using inductive thematic analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Participants median age was 58 years (IQR, 52–72), and 50% were female, 45% were White, 30% were Black, 15% were Asian, 10% were Hispanic/Other persons, and 30% were out-of-state residents. We identified the following seven themes: (1) reducing travel time, (2) minimizing financial burden (decreasing travel-related expenses and lost wages), (3) engaging patients within their comfort space, (4) establishing rapport with patients, (5) limitations of the virtual physical exam, (6) enhancing access to transplant providers (maximizing adherence to follow-up), and (7) lowering risk of communicable diseases.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Integrating telemedicine with in-person visits enhances post-transplant follow-up care. A hybrid model should leverage the strengths of both modalities, ensuring patient access to care and being patient-centered and flexible. Efforts are needed to advance technological tools in physical examination and human connection, and assess patient outcomes. Policymakers and healthcare systems need to incentivize the adoption and expansion of telemedicine in transplant care.</p>\n </section>\n </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70106","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Transplantation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ctr.70106","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Kidney transplant recipients are immunocompromised and require lifelong follow-up. Recipients face geographic, socioeconomic, and logistical challenges when seeking follow-up that can be alleviated using telemedicine. We aimed to understand patient experiences and preferences regarding telemedicine video visits and highlight insights to advance adopting hybrid telemedicine/in-person transplant care.

Methods

We conducted qualitative in-depth, semi-structured interviews with kidney transplant recipients between November 18, 2022, and January 11, 2023. Participants had follow-up at ≥12 months post-transplant via telemedicine at a tertiary transplant center. Study enrollment continued until data saturation was reached (n = 20 participants) when no new information emerged from additional interviews. Transcripts were analyzed using inductive thematic analysis.

Results

Participants median age was 58 years (IQR, 52–72), and 50% were female, 45% were White, 30% were Black, 15% were Asian, 10% were Hispanic/Other persons, and 30% were out-of-state residents. We identified the following seven themes: (1) reducing travel time, (2) minimizing financial burden (decreasing travel-related expenses and lost wages), (3) engaging patients within their comfort space, (4) establishing rapport with patients, (5) limitations of the virtual physical exam, (6) enhancing access to transplant providers (maximizing adherence to follow-up), and (7) lowering risk of communicable diseases.

Conclusions

Integrating telemedicine with in-person visits enhances post-transplant follow-up care. A hybrid model should leverage the strengths of both modalities, ensuring patient access to care and being patient-centered and flexible. Efforts are needed to advance technological tools in physical examination and human connection, and assess patient outcomes. Policymakers and healthcare systems need to incentivize the adoption and expansion of telemedicine in transplant care.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.