Document Detail

An evaluation of a self-management package for people with diabetes at risk of chronic kidney disease.
MedLine Citation:
PMID:  23317539     Owner:  NLM     Status:  MEDLINE    
AIMS AND OBJECTIVES: The overall purpose was to develop, test and evaluate an educational package to help people with diabetes self-manage their risk of developing chronic kidney disease (CKD), one of the main complications of diabetes.
BACKGROUND: Management of people in primary care who have both CKD and diabetes can be controlled by strict blood pressure (BP) and blood sugar control and advice on lifestyle changes, such as smoking cessation. However, there is little evidence to support the assertion that self-management can slow the rate of kidney disease progression.
DESIGN: A mixed-method longitudinal study. Development of the self-management package was informed by the findings of a case study in six GP Practices and also through interviews with 15 patients.
METHODS: Testing of the self-management package was undertaken in the same six Practices, with one additional control Practice. Patients with Type 1 or Type 2 diabetes at risk of kidney disease were included. Outcomes in patients in the participating surgeries who did receive a pack (n = 116) were compared with patients in the control group (n = 60) over 6 time points.
RESULTS: At the end of the study (time point 6), the intervention group had a mean systolic BP of 4.1 mmHg lower and mean diastolic BP of 2.7 mmHg lower than in the control group.
CONCLUSION: Self-management techniques such as understanding of, and subsequent concordance with, prescribed BP medication may contribute to a reduction in BP, which in turn will reduce cardiovascular risk.
RELEVANCE TO CLINICAL PRACTICE: This study contributes to the evidence base for self-management of early kidney disease. Although the exact reason for reduced BP in the intervention group is unclear, the importance of practitioner understanding of kidney disease management and patient understanding of BP medication are likely to be the contributing factors.
Nicola Thomas; Rosamund Bryar
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-15
Journal Detail:
Title:  Primary health care research & development     Volume:  14     ISSN:  1477-1128     ISO Abbreviation:  Prim Health Care Res Dev     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-06     Completed Date:  2014-02-19     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  100897390     Medline TA:  Prim Health Care Res Dev     Country:  England    
Other Details:
Languages:  eng     Pagination:  270-80     Citation Subset:  IM    
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MeSH Terms
Diabetes Mellitus, Type 1 / complications*
Diabetes Mellitus, Type 2 / complications*
Diabetic Nephropathies / prevention & control*
Hypertension / drug therapy
Longitudinal Studies
Middle Aged
Patient Education as Topic / methods,  standards*
Qualitative Research
Renal Insufficiency, Chronic / etiology,  prevention & control*
Self Care*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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