Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial

Tom Blakeman; Christian Blickem; Anne Kennedy; David Reeves; Peter Bower; Hannah Gaffney; Caroline Gardner; Victoria Lee; Praksha Jariwala; Shoba Dawson; Rahena Mossabir; Helen Brooks; Gerry Richardson; Eldon Spackman; Ivaylo Vassilev; Carolyn Chew-Graham; Anne Rogers

doi:10.1371/journal.pone.0109135

Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial

Tom Blakeman, Christian Blickem, Anne Kennedy, David Reeves, Peter Bower, Hannah Gaffney, Caroline Gardner, Victoria Lee, Praksha Jariwala, Shoba Dawson, Rahena Mossabir, Helen Brooks, Gerry Richardson, Eldon Spackman, Ivaylo Vassilev, Carolyn Chew-Graham, Anne Rogers

Centre for Health Economics

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	e109135
Journal	PLoS ONE
Volume	9
Issue number	10
DOIs	https://doi.org/10.1371/journal.pone.0109135
Publication status	Published - 16 Oct 2014

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10.1371/journal.pone.0109135

Cite this

Blakeman, T., Blickem, C., Kennedy, A., Reeves, D., Bower, P., Gaffney, H., Gardner, C., Lee, V., Jariwala, P., Dawson, S., Mossabir, R., Brooks, H., Richardson, G., Spackman, E., Vassilev, I., Chew-Graham, C., & 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. https://doi.org/10.1371/journal.pone.0109135

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title = "Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial",

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.",

author = "Tom Blakeman and Christian Blickem and Anne Kennedy and David Reeves and Peter Bower and Hannah Gaffney and Caroline Gardner and Victoria Lee and Praksha Jariwala and Shoba Dawson and Rahena Mossabir and Helen Brooks and Gerry Richardson and Eldon Spackman and Ivaylo Vassilev and Carolyn Chew-Graham and Anne Rogers",

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Blakeman, T, Blickem, C, Kennedy, A, Reeves, D, Bower, P, Gaffney, H, Gardner, C, Lee, V, Jariwala, P, Dawson, S, Mossabir, R, Brooks, H, Richardson, G , Spackman, E, Vassilev, I, Chew-Graham, C & Rogers, A 2014, 'Effect of information and telephone-guided access to community support for people with chronic kidney disease: randomised controlled trial', PLoS ONE, vol. 9, no. 10, pp. e109135. https://doi.org/10.1371/journal.pone.0109135

TY - JOUR

T1 - Effect of information and telephone-guided access to community support for people with chronic kidney disease

T2 - randomised controlled trial

AU - Blakeman, Tom

AU - Blickem, Christian

AU - Kennedy, Anne

AU - Reeves, David

AU - Bower, Peter

AU - Gaffney, Hannah

AU - Gardner, Caroline

AU - Lee, Victoria

AU - Jariwala, Praksha

AU - Dawson, Shoba

AU - Mossabir, Rahena

AU - Brooks, Helen

AU - Richardson, Gerry

AU - Spackman, Eldon

AU - Vassilev, Ivaylo

AU - Chew-Graham, Carolyn

AU - Rogers, Anne

PY - 2014/10/16

Y1 - 2014/10/16

N2 - 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.

AB - 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.

U2 - 10.1371/journal.pone.0109135

DO - 10.1371/journal.pone.0109135

M3 - Article

C2 - 25330169

SN - 1932-6203

VL - 9

SP - e109135

JO - PLoS ONE

JF - PLoS ONE

IS - 10

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