Brinda Ramachandran_A prospective study to report the impact of

A prospective study to report the

impact of consent on Cornea Retrieval Brinda P Ramachandran1 Virender Sangwan2 Usha Gopinathan1

Ramayamma International Eye Bank L V Prasad Eye Institute, Hyderabad

Conflict of Interest

Financial Disclosure NONE

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.

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.

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

Methodology i. ii.

Study duration : 6 months 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 Counselors v. Questionnaire was filled for every approach

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

Counseling the Donor family •

Methodology Deciding to approach - Identifying the Decision maker/Influencer Timing of approach Steps in counseling • Introduction • Facts about eye donation • Objection handling • Closing & Withdrawal

Data Analysis SPSS ver 17.0 software for windows - Univariable analysis – Chi Square test - Multivariable logistic regression analysis

Results -

415 NoK were approached

- 306 consented for eye donation Consent rate of 73%

Results Age of donor (yrs) 0 – 20 21 – 40 41 – 60 >60

Odds Ratio 0.54 0.52 0.42 1.00

P value 0.182 0.046 0.006

Age of Donor was significantly associated with consent

Results Age of next of Kin (yrs) 0 – 20 21 – 40 41 – 60 >60

Odds Ratio

P value

3.08 (1.21,7.86) 3.03 (1.17,7.78) 1.00

0.019 0.022

Age of Nok was significantly associated with consent

Results Gender (Next of Kin) Odds Ratio

Male Female

315 70

1.17(0.65,2.12) 1.00

P value

0.602

Gender of NoK – not significantly associated

Results Consent by Relationship of NoK

Parents Children Siblings Spouse Others

success/request

(%)

49/65 139/184 40/61 43/64 35/42

75 75 65 67 83

The relationship of the donor has not played any role with regard to consent for eye donation

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

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%.

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.

Acknowledgement - Donor Families - Hyderabad Eye Institute (HEI)

Thank you!

L V Prasad Eye Institute www.lvpei.org

Excellence

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