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Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial

Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial
Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial
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 odds-ratio = 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.
1932-6203
1-15
Blakeman, Tom
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Blickem, Christian
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Kennedy, Anne P.
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Reeves, Davd
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Bower, Peter
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Gaffney, Hannah
606abd93-9d33-43e6-bea0-259c28977e5a
Gardner, Caroline
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Lee, Victoria
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Jariwala, Praksha
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Dawson, Shoba
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Mossabir, Rahena
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Brooks, Helen
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Richardson, Gerry
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Spackman, Eldon
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Vassilev, Ivaylo
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Chew-Graham, Carolyn
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Rogers, Anne
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Blakeman, Tom
805f6f85-5cf2-4c4b-b6b6-c94ee0e46a8e
Blickem, Christian
cc3228ac-f56e-4dca-9aae-cbb6bfac4fb3
Kennedy, Anne P.
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Reeves, Davd
c6a91f55-e3dd-4447-b3c7-b3b2a8691e16
Bower, Peter
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Gaffney, Hannah
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Gardner, Caroline
d99612f8-f7d7-4b42-9d4b-287202c8117c
Lee, Victoria
49d81914-cd51-4e61-9cd1-cef1cb069d1e
Jariwala, Praksha
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Dawson, Shoba
38eacadd-d663-4733-8fd1-1e91dc7a9966
Mossabir, Rahena
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Brooks, Helen
0056a0c8-f97a-4215-99e1-652291fcd6eb
Richardson, Gerry
95b61844-048d-4876-a38a-5df8b22eb0c8
Spackman, Eldon
af801fbe-0b52-4348-ba90-0d305bda77d7
Vassilev, Ivaylo
d76a5531-4ddc-4eb2-909b-a2a1068f05f3
Chew-Graham, Carolyn
530beade-2b1c-4eea-846f-1fcef0585ca5
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7

Blakeman, Tom, Blickem, Christian, Kennedy, Anne P., Reeves, Davd, Bower, Peter, Gaffney, Hannah, Gardner, Caroline, Lee, Victoria, Jariwala, Praksha, Dawson, Shoba, Mossabir, Rahena, Brooks, Helen, Richardson, Gerry, Spackman, Eldon, Vassilev, Ivaylo, Chew-Graham, Carolyn and Rogers, Anne (2014) Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial. PLoS ONE, 9 (10), 1-15, [e109135]. (doi:10.1371/journal.pone.0109135).

Record type: Article

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 odds-ratio = 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.

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e-pub ahead of print date: 16 October 2014
Published date: 16 October 2014
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 372908
URI: http://eprints.soton.ac.uk/id/eprint/372908
ISSN: 1932-6203
PURE UUID: c81cd830-69d8-4d54-bc0d-b2a095a31f32
ORCID for Anne P. Kennedy: ORCID iD orcid.org/0000-0003-4570-9104
ORCID for Ivaylo Vassilev: ORCID iD orcid.org/0000-0002-2206-8247

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Date deposited: 24 Dec 2014 15:11
Last modified: 15 Mar 2024 03:47

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Contributors

Author: Tom Blakeman
Author: Christian Blickem
Author: Anne P. Kennedy ORCID iD
Author: Davd Reeves
Author: Peter Bower
Author: Hannah Gaffney
Author: Caroline Gardner
Author: Victoria Lee
Author: Praksha Jariwala
Author: Shoba Dawson
Author: Rahena Mossabir
Author: Helen Brooks
Author: Gerry Richardson
Author: Eldon Spackman
Author: Ivaylo Vassilev ORCID iD
Author: Carolyn Chew-Graham
Author: Anne Rogers

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