Self-management interventions for adults with chronic kidney disease: A scoping review

Maoliosa Donald, Bhavneet Kaur Kahlon, Heather Beanlands, Sharon Straus, Paul Ronksley, Gwen Herrington, Allison Tong, Allan Grill, Blair Waldvogel, Chantel A. Large, Claire L. Large, Lori Harwood, Marta Novak, Matthew T. James, Meghan Elliott, Nicolas Fernandez, Scott Brimble, Susan Samuel, Brenda R. Hemmelgarn

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Objective To systematically identify and describe self-management interventions for adult patients with chronic kidney disease (CKD). Setting Community-based. Participants Adults with CKD stages 1-5 (not requiring kidney replacement therapy). Interventions Self-management strategies for adults with CKD. Primary and secondary outcome measures Using a scoping review, electronic databases and grey literature were searched in October 2016 to identify self-management interventions for adults with CKD stages 1-5 (not requiring kidney replacement therapy). Randomised controlled trials (RCTs), non-RCTs, qualitative and mixed method studies were included and study selection and data extraction were independently performed by two reviewers. Outcomes included behaviours, cognitions, physiological measures, symptoms, health status and healthcare. Results Fifty studies (19 RCTs, 7 quasi-experimental, 5 observational, 13 pre-post intervention, 1 mixed method and 5 qualitative) reporting 45 interventions were included. The most common intervention topic was diet/nutrition and interventions were regularly delivered face to face. Interventions were administered by a variety of providers, with nursing professionals the most common health professional group. Cognitions (ie, changes in general CKD knowledge, perceived self-management and motivation) were the most frequently reported outcome domain that showed improvement. Less than 1% of the interventions were co-developed with patients and 20% were based on a theory or framework. Conclusions There was a wide range of self-management interventions with considerable variability in outcomes for adults with CKD. Major gaps in the literature include lack of patient engagement in the design of the interventions, with the majority of interventions not applying a behavioural change theory to inform their development. This work highlights the need to involve patients to co-developed and evaluate a self-management intervention based on sound theories and clinical evidence.

Original languageEnglish
Article numbere019814
JournalBMJ open
Volume8
Issue number3
DOIs
Publication statusPublished - Mar 1 2018

Keywords

  • chronic kidney disease
  • person centered-care
  • scoping review
  • self-management

ASJC Scopus subject areas

  • Medicine(all)

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    Donald, M., Kahlon, B. K., Beanlands, H., Straus, S., Ronksley, P., Herrington, G., Tong, A., Grill, A., Waldvogel, B., Large, C. A., Large, C. L., Harwood, L., Novak, M., James, M. T., Elliott, M., Fernandez, N., Brimble, S., Samuel, S., & Hemmelgarn, B. R. (2018). Self-management interventions for adults with chronic kidney disease: A scoping review. BMJ open, 8(3), [e019814]. https://doi.org/10.1136/bmjopen-2017-019814