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

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 selfefficacy (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).