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 - ?. ISSN 1932-6203

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Abstract

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. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN45433299.

Item Type: Article
Uncontrolled Keywords: Aged; Community Health Services; Cost-Benefit Analysis: Female; Health Services Accessibility; Humans; Male; Quality of Life; Renal Insufficiency; Chronic; Social Support; Surveys and Questionnaires; Telephone
Subjects: ?? Aged ??
?? Community Health Services ??
?? Cost-Benefit Analysis ??
?? Female ??
?? Health Services Accessibility ??
?? Humans ??
?? Male ??
?? Quality of Life ??
R Medicine > RA Public aspects of medicine
?? Renal Insufficiency, Chronic ??
?? Social Support ??
?? Surveys and Questionnaires ??
?? Telephone ??
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 06 Jul 2017 09:21
Last Modified: 06 Jul 2017 09:21
URI: http://eprints.keele.ac.uk/id/eprint/3730

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