Self-Management Support in CKD: Patients’ Viewpoints

Patients with chronic kidney disease (CKD) need a “multimodal, person-centered framework” to support disease self-management, with a special focus on everyday strategies, according to a study in BMC Nephrology.

The cross-sectional survey study solicited Australian CKD patients’ views on their desires for support in self-management of their disease. Thirty-six patients filled out a paper survey at a primary care clinic, and another 61 patients completed an online survey.

About 60% of respondents were women; mean age was 56 years and mean time since diagnosis 8 years. The patients expressed the wish for more support in 10 previously identified aspects of self-management, with the highest rating for “keeping a positive attitude taking care of mental and physical health.” Other highly rated areas included “actively participating in healthcare,” “CKD-specific knowledge,” and “noticing and treating signs and symptoms.” Individual patients identified other areas in which they wished for more support.

Young patients expressed a stronger desire for additional support, as did better-educated, employed, and female patients and those with a longer time since diagnosis. About 70% of patients said they would be willing to attend self-management support sessions during work hours. Patients identified a range of potentially helpful methods of information delivery, including written materials and online contact.

The study provides new insight into the self-management needs and preferences of patients living with CKD. “The findings . . . highlight the need for person-centered care and patient engagement in the renal world, as different groups of patients vary in their overall enthusiasm for learning more about effective self-management,” the researchers write. Patient education should focus on everyday strategies—not just information on CKD and medications [Havas K, et al. Person-centered care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support. BMC Nephrol 2018; 18:17].