Carolyn Chew-Graham c.a.chew-graham@keele.ac.uk
Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial.
Chew-Graham, Carolyn
Authors
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.
Citation
Chew-Graham, C. (2014). Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial. PloS one, e109135 - ?. https://doi.org/10.1371/journal.pone.0109135
Acceptance Date | Sep 2, 2014 |
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Publication Date | Oct 16, 2014 |
Journal | PloS one |
Print ISSN | 1932-6203 |
Publisher | Public Library of Science |
Pages | e109135 - ? |
DOI | https://doi.org/10.1371/journal.pone.0109135 |
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 |
Publisher URL | http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0109135 |
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