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Controlling Hypertension through Education and Coaching in Kidney Disease (CHECK-D): protocol of a cluster randomised

Julie A Wright Nunes1,2, Ken Resnicow3,4, Caroline Richardson5

  • 1Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, Michigan, USA juwright@med.umich.edu.

BMJ Open
|August 1, 2023
PubMed

Insights

This study tests if early education and motivational interviewing health coaching improve blood pressure control in chronic kidney disease (CKD) patients. The goal is to enhance patient knowledge and self-efficacy for better health outcomes.

Area of Science:

  • Nephrology
  • Public Health
  • Health Education

Background:

  • Chronic kidney disease (CKD) affects millions, with suboptimal blood pressure (BP) control being a major contributor to cardiovascular morbidity and mortality.
  • Less than 40% of CKD patients achieve recommended BP targets due to barriers like poor understanding of their condition and self-management.
  • Effective interventions are needed to improve patient engagement and adherence to BP management strategies in CKD.

Purpose of the Study:

  • To evaluate the impact of early primary care-based CKD education combined with motivational interviewing (MI)-based health coaching on patient behaviors related to BP control.
  • To assess the intervention's effect on increasing patient knowledge, self-efficacy, and motivation for managing CKD and BP.
  • To provide data for developing sustainable, patient-centric interventions to improve quality of life and outcomes for CKD stages 3-5 patients.

Main Methods:

  • A cluster randomized controlled trial involving 350 patients with CKD stages 3-5 in a primary care setting.
  • The intervention group receives clinician-delivered education followed by 12 months of MI-based health coaching.
  • Outcomes will be compared between the intervention and control groups, utilizing continuous quality improvement (CQI) and systems methodologies.

Main Results:

  • This section is to be filled after the study's completion and data analysis.
  • The study aims to demonstrate significant improvements in BP control metrics within the intervention group.
  • Anticipated results include enhanced patient knowledge, increased self-efficacy, and higher motivation levels impacting health behaviors.

Conclusions:

  • Early CKD education coupled with MI-based health coaching holds promise for improving BP control and patient outcomes.
  • This multidisciplinary, patient-coaching approach can be integrated early in the CKD care continuum.
  • Findings will inform future dissemination of effective, technology-supported interventions for CKD management.
Abstract

Keywords:
Chronic renal failureEDUCATION & TRAINING (see Medical Education & Training)HypertensionNephrologyPRIMARY CARE

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