Agneta A Pagels1, Britta Hylander2, Michael Alvarsson2. 1. Department of Nephrology, Karolinska University Hospital, Stockholm, Sweden. 2. Karolinska Institutet, Department of Medicine & Karolinska University Hospital, Department of Nephrology, Stockholm, Sweden.
Abstract
BACKGROUND: Diabetes is currently the most common cause of kidney disease among patients receiving renal replacement therapy. Pedagogical interventions to promote self-management and secondary prevention have been shown to be effective in delaying disease progression. OBJECTIVES AND DESIGN: A non-randomised, quasi-experimental design ('uncontrolled before and after') to evaluate the effects of a group-based, multidisciplinary and multidimensional support programme in patients with diabetic kidney disease. The programme comprised 1) Disease-related knowledge, 2) Skills training and increased self-care agency 3) A motivational approach, with group discussions, participant questions and narratives, setting and follow-up of individual health goals. PARTICIPANTS: Fifty-eight patients with diabetic kidney disease. OUTCOME MEASURES: Glycated haemoglobin (HbA1c), urine albumin/creatinine ratio, blood pressure, body mass index, waist, physical activity and participant experiences from the programme. RESULTS: The evaluation indicated positive effects on HbA1c, albuminuria and physical activity at follow-up after four months. The proportion of patients achieving blood pressure targets increased. The participants reported improved understanding of their health condition and treatment regime. CONCLUSION: The multidimensional support programme, addressing health-promoting factors and self-management in small patient groups, has a potential to effectively reduce HbA1c and may have some beneficial effects which contribute to health promotion in patients with diabetic kidney disease. This mode of a multidimensional support programme should continue to develop, with longer term follow-up and further evaluations with appropriate research designs.
BACKGROUND:Diabetes is currently the most common cause of kidney disease among patients receiving renal replacement therapy. Pedagogical interventions to promote self-management and secondary prevention have been shown to be effective in delaying disease progression. OBJECTIVES AND DESIGN: A non-randomised, quasi-experimental design ('uncontrolled before and after') to evaluate the effects of a group-based, multidisciplinary and multidimensional support programme in patients with diabetic kidney disease. The programme comprised 1) Disease-related knowledge, 2) Skills training and increased self-care agency 3) A motivational approach, with group discussions, participant questions and narratives, setting and follow-up of individual health goals. PARTICIPANTS: Fifty-eight patients with diabetic kidney disease. OUTCOME MEASURES: Glycated haemoglobin (HbA1c), urine albumin/creatinine ratio, blood pressure, body mass index, waist, physical activity and participant experiences from the programme. RESULTS: The evaluation indicated positive effects on HbA1c, albuminuria and physical activity at follow-up after four months. The proportion of patients achieving blood pressure targets increased. The participants reported improved understanding of their health condition and treatment regime. CONCLUSION: The multidimensional support programme, addressing health-promoting factors and self-management in small patient groups, has a potential to effectively reduce HbA1c and may have some beneficial effects which contribute to health promotion in patients with diabetic kidney disease. This mode of a multidimensional support programme should continue to develop, with longer term follow-up and further evaluations with appropriate research designs.
Authors: Stephanie Anna Lenzen; Ramon Daniëls; Marloes Amantia van Bokhoven; Trudy van der Weijden; Anna Beurskens Journal: PLoS One Date: 2017-11-27 Impact factor: 3.240
Authors: Clarissa J Diamantidis; Hayden B Bosworth; Megan M Oakes; Clemontina A Davenport; Jane F Pendergast; Sejal Patel; Jivan Moaddeb; Huiman X Barnhart; Peter D Merrill; Khaula Baloch; Matthew J Crowley; Uptal D Patel Journal: Contemp Clin Trials Date: 2018-04-10 Impact factor: 2.226