Increasing Organ Donor Registration Through Nudging in a Family Practice

DOI: 10.3238/zfa.2020.0008-0011

german translation / full article

Michael Haberland

Keywords: family medicine nudging organ transplantation

BackgroundIn 2017, Germany had the lowest number of deceased donors per million population of all countries organized in in Eurotransplant, with only 615 post-mortal organ donors. In 2017, more than 10.000 patients were waiting for a donation, and 917 of these died while on the waiting list. Although the majority of the German population is in favor of organ transplantation, only a minority carry an organ donor card. In this study, we examined the percentage of potential organ donors in a family practice and whether nudging could be used to increase organ donor registration.MethodsThis study was conducted in a single family practice in Bavaria from January until June 2018. All patients between 16 and 65 who visited the practice for an encounter were interviewed with a questionnaire about their views on organ transplantation. An organ donor registration card was offered to all participants. Patients who were registered with the practice were asked two additional questions used as a nudge. The data was analyzed with Excel and tested for statistical significance using the chi-square test.ResultsFrom 791 questionnaires issued, 92 % (n = 726) could be analyzed. 71 % (n = 519) did not carry a donor registration card, but only 7 % (n = 37) of those opposed organ transplantation. 46 % (n = 239) of patients without a donor registration card indicated that they needed further information. 33 % (n = 172) requested a donor registration card. Nudging significantly increased the percentage of patients requesting a donor registration card (19 % vs 38 %, p < 0.005). This intervention increased the percentage of card carriers from 29 % to 52 %.ConclusionsThis study demonstrated that nudging in a primary care practice sigificantly increased organ donor registration. However, more than 60 % of the nudged patients without a donor registration card, who would choose a transplant for themselves, did not register as potential organ donors. Keywordsorgan transplantation; family medicine; nudging

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