Structured Educational Interventions in CKD

The purpose of this project is to enable the development of a highly specific protocol for a systematic review (SR) of existing literature on structured education interventions in chronic kidney disease.

Patient self-management is the cornerstone of chronic disease management.  The degree of self-management an individual patient exhibits depends on the information and tools they are equipped with as well as their inherent ability.  This emphasises the paramount importance of patient education programmes in achieving effective self-management and enabling patients to make decisions about their treatment.

Gold standard structured patient education is: well-planned to covers all aspects of CKD management; relevant and adaptable to individuals’ needs and backgrounds; accompanied by a written outline; delivered by trained educators; quality assured and audited (NCC-CC, 2006).

Unlike the high quality structured education programmes that exists for diabetes e.g. DESMOND, there is nothing similar for CKD.  Despite the direct comparability; both are long-term conditions requiring self-management, primarily of lifestyle factors which necessitates complex skills and patient motivation.

A SR will enable recommendations as to what elements of knowledge; professional support and lifestyle a structured patient education intervention should address by reviewing what: exists; is (in)effective and is missing.

A major strength of this proposal is that the review builds on existing patient-centred qualitative research undertaken at the MRI’s Renal Department. Analysis of this data has demonstrated that patients themselves articulate a need for a more structured approach to education.

Future steps: A SR is the initial phase of the MRC’s framework for developing complex interventions.  With the developed protocol and publication, we wish to undertake the review and consider its findings alongside the in-depth analysis of our qualitative data, to develop a theory for a complex intervention; and then model said intervention.