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Table 1 Characteristics of Studies Included in the Systematic Review

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

  1. AUS Australia, US United States, GCG Greater China Group (Mainland China, Hong Kong, Macau and Taiwan), CAN Canada, NED Netherlands, UK United Kingdom, ALG Algeria, NZ New Zealand, JPN Japan
  2. T1DM Type 1 Diabetes, T2DM Type 2 Diabetes, Mo Months
  3. Lifestyle modification, targeting nutrition management, weight management or physical exercise; Medical-behavior modification, targeting medicine adherence, disease cognition and complication control; Multi-factorial modifications, combine lifestyle and medical behavior;
  4. Iintervention; cControl group