Effectiveness of self-management program in people with chronic kidney disease: A pragmatic randomized controlled trial

Aims : To examine the effectiveness of a self-management intervention compared with usual care in adults with chronic kidney disease on self-management, knowledge, self-efficacy, health-related quality of life and blood pressure. Design : A parallel group randomized controlled trial. Methods : Patients aged ≥ 18 years with chronic kidney disease stages 3−5 were recruited between November 2015 and June 2016. Participants were randomly allocated into either the intervention (n = 68) or control group (n = 67). The control group received usual care, while the intervention group received usual care plus a self-management program from a nurse. The intervention was guided by social cognitive theory and included a face-to-face educational session followed by telephone support. Both groups were followed for 16 weeks. Results : There were no significant differences in self-management, knowledge, self-efficacy, health-related quality of life, and blood pressure between the two groups at baseline. At week 16, compared with the control group, large effect sizes for improved self-management, knowledge, and self-efficacy were detected. For health-related quality of life, the physical and mental health components significantly improved. However, no significant differences in either systolic or diastolic blood pressures were found. Conclusion : In earlier stages of chronic kidney disease, a simple self-management education benefits patients. Impact: Effective self-management in the earlier stages of chronic kidney disease contributes to slowing its progression, improving health outcomes, and lowering the burden on healthcare systems. This study demonstrated that social cognitive theory increases chronic kidney disease self-management by strengthening knowledge and self-efficacy. Nurses can provide this education.