IMPAKT (Improving Access to Kidney Transplants)

IMPAKT (Improving Access to Kidney Transplant) comprised three discrete studies investigating the existing disparity in access to kidney transplants between Indigenous and non-Indigenous Australians. The project looked at how health systems in different Australian States and Territories provide transplant services to patients. It has documented the experiences of Aboriginal and Torres Strait Islander patients, examining in some detail their access to and use of transplant services.

The study includes an in-depth exploration of patients’ and staff perceptions and attitudes as well as their suggestions for improvements. The IMPAKT team visited and worked in 26 locations across the Northern Territory, SA, NSW, Queensland and WA, including urban centres, large regional towns, small remote towns and Indigenous communities.

Some of the project outcomes included: 

Indigenous patients’ interest in transplant – 

• Indigenous patients are interested in transplant but unclear about the process. They also wish to be better informed about their treatment plans
• patient education is not sufficiently targeted to the cultural, language and literacy needs of Indigenous people.

Clinical uncertainties – 

• many key transplant decision-makers are uncertain about the benefits of transplant for Indigenous patients
• there is a widespread perception among health service providers that Indigenous patients are less likely to fully carry out treatment requirements (i.e. they are seen as less ‘compliant’).

Systemic issues –

• communication issues profoundly affect patient/provider interactions at all levels in ways that disadvantage Indigenous patients.
• under-resourcing and systems deficits, especially in the regional areas, reduce capacity to address the needs of Indigenous patients
• distance and remoteness are critical aspects of the context of patient care.

Key findings from the research highlight that Aboriginal and Torres Strait Islander patients are interested in transplants but are unclear about the process and that patient education is not sufficiently targeted to the cultural, language and literacy needs of Indigenous people.

In order to transfer these research findings, the project team from IMPAKT plan to work collaboratively with service providers to develop an appropriate education package targeting Aboriginal and Torres Strait Islander people and patients.

Related resources:

• Anderson, K., Cunningham, J., Devitt, J., Preece, C. and Cass, A.. 2012,“Looking back to my family”: Indigenous Australian patients’ experience of hemodialysis, BMC Nephrology, vol. 13, no. 114. pp 1–15
• Cass, A., Devitt, J., Preece, C., Cunningham, J. et al. 2004, 'Barriers to Access by Indigenous Australians to Kidney Transplantation: The IMPAKT Study', Nephrology, vol. 9, S144–46
• Cunningham, J., Cass, A. & Arnold, P. C. 2005, 'Bridging the Treatment Gap for Indigenous Australians', MJA, vol. 182(10), pp. 505–56
• Cunningham, J., Cass, A., Anderson, K. et al. 2006, Australian Nephrologists' Attitudes towards Living Kidney Donation, Nephrol. Dial. Transplant., vol. 21(5), pp. 1178–83
• IMPAKT Fact Sheet