Blakeman, T and Blickem, C and Kennedy, A and Reeves, D and Bower, P and Gaffney, H and Gardner, C and Lee, V and Jariwala, P and Dawson, S and Mossabir, R and Brooks, H and Richardson, G and Spackman, E and Vassilev, I and Chew-Graham, C and Rogers, A (2014) Effect of Information and Telephone-Guided Access to Community Support for People with Chronic Kidney Disease: Randomised Controlled Trial. PLOS ONE, 9 (10). e109135-e109135. ISSN 1932-6203
Blakeman Blickem PLOSone 2014.pdf - Published Version
Available under License Creative Commons Attribution.
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.
|Uncontrolled Keywords:||MD Multidisciplinary|
|Subjects:||R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
|Divisions:||Public Health Institute|
|Publisher:||PUBLIC LIBRARY SCIENCE|
|Date Deposited:||18 Feb 2016 14:37|
|Last Modified:||18 Feb 2016 14:37|
|DOI or Identification number:||10.1371/journal.pone.0109135|
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