Key result
New trial tests if clinician education and health coaching improve BP control in CKD.
Why the study?
Less than 40% of patients with CKD achieve recommended BP targets, driven by barriers such as a lack of understanding of their diagnosis and how to optimise their health.
Does clinician-delivered education and MI-based health coaching improve blood pressure control in patients with CKD stages 3-5?
RCT (n=350)
Cluster
Does clinician-delivered education and MI-based health coaching improve blood pressure control in patients with CKD stages 3-5?
This protocol outlines a cluster randomized trial to evaluate whether early CKD education and motivational interviewing-based health coaching can improve blood pressure control in patients with CKD stages 3-5.
Will provide first RCT evidence on education plus coaching for BP control in CKD; leaves open whether to adopt in practice.
INTRODUCTION: Chronic kidney disease (CKD) affects 30 million Americans. Early management focused on blood pressure (BP) control decreases cardiovascular morbidity and mortality. Less than 40% of patients with CKD achieve recommended BP targets due to many barriers. These barriers include a lack of understanding of the implications of their diagnosis and how to optimise their health.This cluster randomised control trial hypothesises that the combination of early primary care CKD education, and motivational interviewing (MI)-based health coach support, will improve patient behaviours aligned with BP control by increasing patient knowledge, self-efficacy and motivation. The results will aid in sustainable interventions for future patient-centric education and coaching support to improve quality and outcomes in patients with CKD stages 3-5. Outcomes in patients with CKD stages 3-5 receiving the intervention will be compared with similar patients within a control group. Continuous quality improvement (CQI) and systems methodologies will be used to optimise resource neutrality and leverage existing technology to support implementation and future dissemination. The innovative approach of this research focuses on the importance of a multidisciplinary team, including off-site patient coaching, that can intervene early in the CKD care continuum by supporting patients with education and coaching. METHODS AND ANALYSIS: We will test impact of BP control when clinician-delivered education is followed by 12 months of MI-based health coaching. We will compare outcomes in 350 patients with CKD stages 3-5 between intervention and control groups in primary care. CQI and systems methodologies will optimise education and coaching for future implementation and dissemination. ETHICS AND DISSEMINATION: This study was approved by the University of Michigan Institutional Review Boards (IRBMED) HUM00136011, HUM00150672 and SITE00000092 and the results of the study will be published on ClinicalTrials.gov, in peer-reviewed journals, as well as conference abstracts, posters and presentations. TRIAL REGISTRATION NUMBER: NCT04087798.
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Nunes et al. (2023) conducted an RCT in Chronic kidney disease (CKD) stages 3-5 (n=350). Clinician-delivered education and motivational interviewing (MI)-based health coaching vs. Control group was evaluated on Blood pressure control and patient behaviours aligned with BP control. This protocol describes a cluster randomized controlled trial to evaluate whether clinician-delivered education followed by 12 months of health coaching improves blood pressure control in CKD.
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