Klinisch I - P09 - Barriers and facilitators in regular gynaecological screening of fe­male renal transplant recipients

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F Hinten, R. Hermens, K. Meeuwis, M. van der Linden, L. Massuger, W. Melchers, L.B. Hilbrands, J. de Hullu

Chair(s): prof. dr. Hans de Frijter, neuroloog, LUMC

Thursday 10 march 2016

13:00 - 13:30h at Foyer

Categories: Postersessie

Parallel session: Postersessies XI - Opgesplitst in 3 tijdblokken en 3 categoriëen (klinisch, basaal, donatie)

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Background:
Organ transplant recipients have an increased risk of Human Papillomavirus (HPV) related anogenital (pre)malignancies. Several guidelines recommend to perform annual cervical cancer screening in women who underwent renal transplantation. However, participation rate of female renal transplant recipients (RTRs) in gynaecological screening is low. The aim of this study is to identify barriers and facilitators for annual gynaecological screening in Dutch female RTRs from both patient and professional perspective and to present suggestions for increasing the participation rate.

Methods:
A qualitative study was performed with women who underwent a renal transplantation at the Radboud university medical center and nephrologists specialized in care for renal transplant patients, using explorative semi-structured interviews in focus groups. In total four focus groups were conducted: two with female RTRs and two with nephrologists.

Results:
In total 14 female RTRs and 13 nephrologists participated. The main barriers mentioned by both nephrologists and female RTRs were similar: examination by general practitioner and/or assistant is experienced as more uncomfortable and less reliable compared to the examination by a gynaecologist, limited knowledge of professionals and limited information supply to patients. However, female RTRs focused more on the impact of the examination. Total agreement was found on the facilitators: a reminder, a checklist, integration of gynaecological examination in yearly check-up, self-sampling, and information supply at the right moment. 

Conclusions:
Based on these findings we suggest that female RTRs receive a checklist one year after transplantation with the examinations they should undergo. Furthermore, HPV self-sampling in the yearly check-up by the nephrologist would obviate barriers and meet the main facilitators. Implementing these changes might improve the participation rate of female RTRs in gynaecological screening.