From: Self-management interventions for chronic kidney disease: a systematic review and meta-analysis
Study | Participants Characteristics | Age | Intervention Format and Delivery | Type of Intervention | Framework | Comparator | Primary Outcomes | Study Duration | Country | Sample size |
---|---|---|---|---|---|---|---|---|---|---|
Meuleman 2017 [47] | CKD1–4(GFR ≥ 20)/Hypertension | 55.6 ± 11.7i; 54.7 ± 16.0c | Sodium restriction; Delivered by health psychologists and dietician | Lifestyle modifications; Face-to-face | Coventry, Aberdeen and London Refined (CALO-RE) taxonomy | Usual care | Sodium intake and BP | 38 mo | NED | 67i, 71c |
Rossi 2014 [48] | CKD3–4(GFR 15–59) | 67.76 ± 12.4i; 69.26 ± 12.4c | Renal rehabilitation exercise; Delivered by exercise physiologist and physical therapist | Lifestyle modifications; Face-to-face |  | Usual care | Physical Function Testing, QoL | 3 mo | US | 59i, 48c |
Teng 2013 [49] | CKD1–3 | 63.85 ± 12.78 | Lifestyle Modification Program; Delivered by clinics’ case managers | lifestyle modifications; Face-to-face | Trans-Theoretical Model (TTM) | Usual care | Diet modification, Exercise | 12 mo | Taiwan | 52i, 51c |
Mustata 2011 [50] | CKD3–4(GFR15–60) | 72.5 (59, 79)i; 64 (55, 73)c | Exercise; Delivered by physical therapist | Lifestyle modifications; Face-to-face |  | Usual care | Physical impairment | 12 mo | CAN | 10i, 10c |
Campbell 2008 [51] | CKD4–5(GFR<30) | 69.75 ± 12.15; | Individualized nutritional counseling: providing individualized nutritional counseling (once every 2 weeks), telephone counseling, and self-management principles; Delivered by dietitian | Lifestyle modifications; Telehealth |  | Usual care | SF-36, SGA | 3 mo | AUS | 23i, 24c |
Flesher 2011 [52] | CKD3–4(GFR 20–60)/Hypertension | 63.4 ± 12.1i; 63.4 ± 11.8c | Cooking and exercise programs; Delivered by certified exercise physiologist (CEP), nurse, dietitian, cook educator and exercise physiologist | Lifestyle modifications; Face-to-face | Stanford Patient Education | Usual care | CV risk factors, progression of CKD, self-efficacy & self-management | 12 mo | CAN | 23i, 17c |
Leehey 2009 [53] | CKD2–4/Diabetes & obesity | 66 (range 55–81) | Aerobic exercise | Lifestyle modifications; Face-to-face |  | Usual care | Proteinuria | 6 mo | US | 7i, 4c |
Mekki 2010 [54] | CKD2 | 61 ± 14 | Mediterranean diet | Lifestyle modifications; Face-to-face |  | Usual care | Lipids and apolipoproteins | 3 mo | ALG | 20i, 20c |
Howden 2015 [55] | CKD3–4(GFR 25–60)/CVD | 60.2 ± 9.7i; 62.0 ± 8.4c | Exercise training and lifestyle program; Delivered by nurse practitioner, exercise physiologist, dietitian, psychologist, credentialed diabetes educator and social worker | Lifestyle modifications; Face-to-face |  | Usual care | Efficacy, Adherence and Safety | 12 mo | AUS | 36i, 36c |
Byrne 2011 [56] | CKD1–4(GFR < 90)/Hypertension | 62.8 ± 11.8 | Evidence-based structured group educational intervention (CHEERS); Delivered by nurse | Medical-behavior modifications; Face-to-face |  | Usual care | Recruitment, uptake of the intervention and patient satisfaction | 6mo | UK | 40i, 41c |
van Zuilen 2011 [57] | CKD2–4(GFR 20–70) | 58.9 ± 13.1i; 59.3 ± 12.8c | Nurse practitioner (NP) care; Delivered by nephrologist | Medical-behavior modifications; Face-to-face |  | Usual care | Composite nonfatal myocardial infarction, stroke and cardiovascular mortality | 60 mo | NED | 352i, 346c |
Hotu 2010 [58] | DN(> 0.5 g proteinuria/24 h and Scr 130-300umol/L)& Hypertension | 60 ± 7.1c; 63 ± 6.6i | community visi t(medication adherence and BP control) Delivered by healthcare assistant | Medical-behavior modifications; Face-to-face |  | Usual care | Change in BP. | 4.5 mo | NZ | 30i, 28c |
Williams 2012b [59] | CKD2–4/T1/T2DM&CVD | 74.31 ± 8.37 | multifactorial intervention designed to improve medication self-efficacy and adherence; Delivered by nurse | Medical-behavior modifications; Face-to-face & Telehealth | Health Belief Model (HBM) | Usual care | Medication self-efficacy & adherence | 12 mo | AUS | 24i, 24c |
Joboshi 2017 [60] | CKD1–5 | 67 ± 11.5i; 70.1 ± 11.1c | Participants’ behavioral targets included blood pressure management, medication management, and nutritional management of salt and potassium intakes; Delivered by nurse | Multifactorial modifications; Face-to-face |  | Usual care | Self-efficacy and self-management behavior | 3 mo | JPN | 32i, 29c |
Ishani 2016 [61] | CKD3–5(GFR < 60) | 75.1 ± 8.1 | Telehealth and interprofessional case management (BP, volume status, proteinuria, diabetes mellitus, lipid levels, and depression; health literacy and patient activation); Delivered by nephrologist, nurse practitioner, nurses, clinical pharmacy specialist, psychologist, social worker, telehealth care technician and dietician | Multifactorial modifications; Telehealth | Components of the chronic care model(CCM). | Usual care | Death, hospitalization, emergency department visits, or admission to skilled nursing facilities | 4.5 mo | US | 450i, 150c |
Steed 2005 [62] | CKD1–5/T2DM and microalbuminuria | 59.2 ± 8.8i; 60.3 ± 8.6c | Diabetes self-management and developing problem solving techniques (self-monitoring of blood glucose, diet, exercise and medication) Delivered by diabetes nurse, dietician | Multifactorial modifications; Face-to-face |  | Usual care | QoL | 3 mo | UK | 59i, 65c |
Williams 2012a [63] | CKD3–5/Diabetes | 68 ± 8.3i; 66 ± 10.8c | BP & medication adherence; Delivered by renal specialist nurse | Multifactorial modifications; Face-to-face & Telehealth | Health Belief Model (HBM) | Usual care | BP control, medication adherence | 12 mo | AUS | 36i, 39c |
Chan 2009 [64] | Scr 150-350umol/l /T2DM | 65 ± 7.2 | Treatment compliance and self-care (drug use, insulin injection, self-monitoring of blood glucose, and lifestyle modification); Delivered by dietitian and doctor-nurse team | Multifactorial modifications; Face-to-face |  | Usual care | Death and/or renal end point (Cr > 500umol/L) | 24 mo | HK | 81i, 82c |
Chen 2011 [65] | CKD3–5 | 68.39 ± 12.08 | Interactive individualized education sessions; Delivered by CKD nursing specialists | Multifactorial modifications; Face-to-face & Telehealth | SMS program | Usual care | Improved GFR, No. ofhospitalizations | 12 mo | Taiwan | 27i, 27c |