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Renal medicine
Research
Feasibility of a structured group education session to improve self-management of blood pressure in people with chronic kidney disease: an open randomised pilot trial
  1. Jo Byrne1,
  2. Kamlesh Khunti2,
  3. Margaret Stone2,
  4. Azhar Farooqi3,
  5. Sue Carr1
  1. 1Department of Nephrology, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2Department of Health Sciences, University of Leicester, Leicester, UK
  3. 3East Leicester Medical Practice, Leicester, UK
  1. Correspondence to Dr Jo Byrne; jo.l.byrne{at}uhl-tr.nhs.uk

Abstract

Objectives We aimed to test, at pilot level, a structured group educational intervention to improve self-management of blood pressure in people with chronic kidney disease (CKD). The current paper explores patient acceptability of the intervention.

Design This was an open randomised pilot trial. Participants were randomly assigned to either:

  • A control group (n=41) receiving standard clinical management of hypertension.

  • An intervention group (n=40) receiving standard clinical care plus the educational intervention.

Setting Renal outpatient clinics at a single study centre.

Participants Patients with early CKD and hypertension were identified and approached for recruitment.

Intervention An evidence-based structured group educational intervention (CHEERS) using the principles of social cognitive theory to improve knowledge and self-management skills.

Outcomes Recruitment, uptake of the intervention and patient satisfaction were evaluated to explore patient acceptability of the intervention and to determine any differences between patients regarding recruitment and retention.

Measures Data on age, sex and ethnicity were collected for all patients approached to take part. For recruited patients, data were also collected on self-efficacy (ability to self-manage). Reasons given by patients declining to take part were recorded. Patients attending the educational session also completed an evaluation form to assess satisfaction.

Results A total of 267 patients were approached, and 30% were randomly assigned. Lack of time (48%) and lack of interest (44%) were the main reasons cited for non-participation in the study. Men were significantly more likely to be recruited (p=0.048). The intervention was rated enjoyable and useful by 100% of participants. However, 37.5% of the intervention group failed to attend the educational session after recruitment. Participants failing to attend were significantly more likely to be older (p=0.039) and have lower self-efficacy (p=0.034).

Conclusion The findings suggest that delivering and evaluating an effective structured group educational intervention to promote better blood pressure control in patients with CKD would be challenging in the current context of kidney care.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2011-000381

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    Supplementary materials

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    Footnotes

    • To cite: Byrne J, Khunti K, Stone M, et al. Feasibility of a structured group education session to improve self-management of blood pressure in people with chronic kidney disease: an open randomised pilot trial. BMJ Open 2011;1:e000381. doi:10.1136/bmjopen-2011-000381

    • Funding JB received funding from Kidney Research UK (The Edith Murphy Fellowship Programme: TF/EMP/3/04).

    • Competing interests None.

    • Ethics approval Ethics approval was provided by the Leicestershire, Northamptonshire and Rutland Research Ethics Committee 2 (06/Q2502/4).

    • Contributors JB drafted the manuscript with SC, MS, AF and KK providing critical revision. JB developed the design of the educational intervention and resources, recruited patients, coordinated the implementation of the intervention and undertook all the analyses as part of her PhD supervised by SC, MS, KK and AF. SC, MS, KK and AF designed the study and obtained funding. All contributors have approved the final version of the manuscript.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Details of the educational intervention curriculum and resource folder plus a complete list of the clinical outcomes from the feasibility study are available from the corresponding author jo.l.byrne{at}uhl-tr.nhs.uk. Consent was not obtained but the presented data are anonymised and risk of identification is low.