BTS conference - Using the Japanese KJ Ho method as a qualitative creative problem solving technique to address clinicians’ and young kidney transplant patients’ needs concerning treatment

Introduction
Treatment adherence in kidney transplant patients is particularly challenging during adolescence and young adulthood. This produces adverse consequences such as higher transplant failure, decreased quality of life and increased mortality. A novel qualitative creative problem-solving method (KJ Ho), widely used in Japan, has been applied in the United Kingdom (UK) to disentangle clinicians’ and young kidney transplant patients’ perspectives on this problem area. The study forms the first stage in the development of a user-driven digital intervention to improve long-term treatment adherence. KJ-Ho has contributed widely to clinical practice and knowledge in multiple contexts in Japan; our first application of this method in the UK should similarly contribute to improving post-transplant practice and knowledge.

Methods
KJ Ho is a Japanese creative problem solving method to organize qualitative research data. Clinicians were invited to take part in a two hour creative workshop. Data were analysed in a step-wise approach from which several overarching themes emerged. Similar workshops for patients (aged from 13 – 30 years) and their family members are being conducted. KJ Ho findings will be synthesized with two systematic literature reviews being undertaken in parallel.

Results
Six overarching themes were identified during the clinicians’ workshop: (1) non-adherence; (2) communication; (3) continuity in care; (4) values; (5) family; (6) patient-centred. Similar data concerning young kidney transplant patients’ needs is currently being collected and analysed. Triangulation of the KJ Ho data with standard systematic review outputs will provide a robust evidence base for intervention development.

Discussion
Integration of this original KJ Ho problem-solving method with standard Western systematic literature review methods can better identify factors currently influencing treatment adherence. This co-creation phase will be followed by a co-design stage to produce a digital intervention able to improve treatment adherence among young kidney transplant patients, which will be tested in a future large-scale trial.