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- Title
An evaluation of a self-management package for people with diabetes at risk of chronic kidney disease.
- Authors
Thomas, Nicola; Bryar, Rosamund
- Abstract
Aims and objectivesThe overall purpose was to develop, test and evaluate an educational package to help people with diabetes self-manage their risk of developing chronic kidney disease (CKD), one of the main complications of diabetes. BackgroundManagement of people in primary care who have both CKD and diabetes can be controlled by strict blood pressure (BP) and blood sugar control and advice on lifestyle changes, such as smoking cessation. However, there is little evidence to support the assertion that self-management can slow the rate of kidney disease progression.DesignA mixed-method longitudinal study. Development of the self-management package was informed by the findings of a case study in six GP Practices and also through interviews with 15 patients. MethodsTesting of the self-management package was undertaken in the same six Practices, with one additional control Practice. Patients with Type 1 or Type 2 diabetes at risk of kidney disease were included. Outcomes in patients in the participating surgeries who did receive a pack (n = 116) were compared with patients in the control group (n = 60) over 6 time points.ResultsAt the end of the study (time point 6), the intervention group had a mean systolic BP of 4.1 mmHg lower and mean diastolic BP of 2.7 mmHg lower than in the control group. ConclusionSelf-management techniques such as understanding of, and subsequent concordance with, prescribed BP medication may contribute to a reduction in BP, which in turn will reduce cardiovascular risk. Relevance to clinical practice: This study contributes to the evidence base for self-management of early kidney disease. Although the exact reason for reduced BP in the intervention group is unclear, the importance of practitioner understanding of kidney disease management and patient understanding of BP medication are likely to be the contributing factors.
- Subjects
ENGLAND; CHRONIC kidney failure; PREVENTION of disease progression; BEHAVIOR modification; BLOOD pressure measurement; CLUSTER analysis (Statistics); COMPARATIVE studies; DIABETES; PEOPLE with diabetes; DRUGS; FAMILY medicine; HEALTH behavior; LONGITUDINAL method; RESEARCH methodology; EVALUATION of medical care; METABOLIC regulation; PATIENT compliance; RESEARCH funding; HEALTH self-care; STATISTICS; BODY mass index; CONTROL groups; INTER-observer reliability; REPEATED measures design; DESCRIPTIVE statistics; DISEASE risk factors
- Publication
Primary Health Care Research & Development, 2013, Vol 14, Issue 3, p270
- ISSN
1463-4236
- Publication type
Article
- DOI
10.1017/S1463423612000588