Programmes that help people take charge may make adults with kidney disease self-manage more.

The review

1. 01

   Who took part

   19 trials with 4,414 adults who had chronic kidney disease stages 3 to 5, not on dialysis or a transplant. Their average age was 65, and 63% were men.

2. 02

   What they did

   All the programmes gave people education, goal setting, action plans and help with solving problems, often with a coach. Health workers and coaches ran them by phone, face to face or online, for 1 month to 42 months. The other group got usual care.

3. 03

   What happened

   Across four studies, people in the programmes did more to manage their own care than usual care did. Eight studies found people felt more able to manage, and two found no change in medicine-taking. Quality of life gave weak results, and the paper's figures for one of them do not agree.

What the review found

1. HelpedGoals

   Across four studies, programmes that set goals, made plans and solved problems helped adults do more self-care than usual care.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Write down when and wheretested
   • Rule: With a coach or therapistused

   Pooled analysis of 4 studies with 368 people · vs people who got usual care · they rated themselves · the authors rated their certainty high · ⚠ results look too good to be true; the studies disagreed a lot; whole programmes were tested, so no single part can be credited

2. HelpedMotivation

   Across eight studies, these programmes helped people feel more able to manage their kidney care than usual care.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Write down when and wheretested
   • Rule: With a coach or therapistused

   Pooled analysis of 8 studies · vs people who got usual care · they rated themselves · the authors rated their certainty moderate · ⚠ the studies disagreed a lot; whole programmes were tested, so no single part can be credited

3. No differenceGoals

   Across two studies, the programmes did not change how well people took their medicines compared with usual care.

   • Action: Set a specific goaltested
   • Action: Solve problems step by steptested
   • Rule: Write down when and wheretested
   • Rule: With a coach or therapistused

   Pooled analysis of 2 studies · vs people who got usual care · they rated themselves · the authors rated their certainty very low · ⚠ whole programmes were tested, so no single part can be credited

Source