Effect of Information and Telephone-Guided Access to Community Support for People with Chronic Kidney Disease: Randomised Controlled Trial

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Christian Blickem
  • Anne Kennedy
  • Hannah Gaffney
  • Victoria Lee
  • Praksha Jariwala
  • Shoba Dawson
  • Rahena Mossabir
  • Helen Brooks
  • Gerry Richardson
  • Eldon Spackman
  • Ivaylo Vassilev
  • Carolyn Chew-Graham
  • Anne Rogers

Abstract

Background: Implementation of self-management support in traditional primary care settings has proved difficult, encouraging the development of alternative models which actively link to community resources. Chronic kidney disease (CKD) is a common condition usually diagnosed in the presence of other co-morbidities. This trial aimed to determine the effectiveness of an intervention to provide information and telephone-guided access to community support versus usual care for patients with stage 3 CKD. Methods and Findings: In a pragmatic, two-arm, patient level randomised controlled trial 436 patients with a diagnosis of stage 3 CKD were recruited from 24 general practices in Greater Manchester. Patients were randomised to intervention (215) or usual care (221). Primary outcome measures were health related quality of life (EQ-5D health questionnaire), blood pressure control, and positive and active engagement in life (heiQ) at 6 months. At 6 months, mean health related quality of life was significantly higher for the intervention group (adjusted mean difference = 0.05; 95% CI = 0.01, 0.08) and blood pressure was controlled for a significantly greater proportion of patients in the intervention group (adjusted oddsratio= 1.85; 95% CI = 1.25, 2.72). Patients did not differ significantly in positive and active engagement in life. The intervention group reported a reduction in costs compared with control. Conclusions: An intervention to provide tailored information and telephone-guided access to community resources was associated with modest but significant improvements in health related quality of life and better maintenance of blood pressure control for patients with stage 3 CKD compared with usual care. However, further research is required to identify the mechanisms of action of the intervention.

Bibliographical metadata

Original languageEnglish
Article numbere109135
Pages (from-to)e109135
JournalP L o S One
Volume9
Issue number10
DOIs
Publication statusPublished - 16 Oct 2014

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