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

Tom Blakeman, Christian Blickem, Anne Kennedy, David Reeves, Peter Bower, Hannah Gaffney, Caroline Gardner, Victoria Lee, Praksha Jariwala, Shoba Dawson, Rahena Mossabir, Helen Brooks, Gerry Richardson, Eldon Spackman, Ivaylo Vassilev, Carolyn Chew-Graham, Anne Rogers

Research output: Contribution to journalArticle (Academic Journal)peer-review

32 Citations (Scopus)

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.

TRIAL REGISTRATION: Controlled-Trials.com ISRCTN45433299.

Original languageEnglish
Pages (from-to)e109135
JournalPLoS ONE
Volume9
Issue number10
DOIs
Publication statusPublished - 2014

Keywords

  • Aged
  • Community Health Services
  • Cost-Benefit Analysis
  • Female
  • Health Services Accessibility
  • Humans
  • Male
  • Quality of Life
  • Renal Insufficiency, Chronic
  • Social Support
  • Surveys and Questionnaires
  • Telephone
  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

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