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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
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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
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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
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Gardner, Caroline
d99612f8-f7d7-4b42-9d4b-287202c8117c
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, 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

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Date deposited: 24 Dec 2014 15:11
Last modified: 26 Feb 2021 02:42

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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
Author: Carolyn Chew-Graham
Author: Anne Rogers

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