Table 2.

An overview of the 18 CKD interventions for primary care identified from the primary search

	Intervention type	Author (year)	Main intervention description	Other intervention(s)	Sample size	Country	Summary of findings	Other comments
CKD interventions aimed at healthcare professionals	Educational	Cortes-Sanabria et al. (2008) [28]	Intensive weekly teaching sessions to GP (5 h weekly for 6 months)	Validated test at 0 and 6 months to measure competence	94	Mexico	Increased GP competence, led to improved eGFR and BP control, better prescribing	High enrolment rate. 91 % of GPs increased their clinical competence
		Akbari et al. (2004) [26]	2 h of teaching seminars to GPs, with direct access to advice from nephrologist	Automated reporting of eGFR by laboratory	324	Canada	Increased recognition of CKD	Limited data for evaluation, early study
	Practice group meetings	De Lusignan et al. (2013) [34]	Audit-based education (twice yearly feedback about quality and performance compared with peers)	Education, peer support	23,311	UK	Improved BP control and increased use of ACEi. No differences in eGFR	Large study including 93 different practices
		Humphreys et al. (2012) [16]	Three large practice group meetings with local rapid quality improvement cycles (planned and organised by research collaboration)	Implementation team support	5509	UK	CKD recognition, BP control and proteinuria testing all improved	Included 19 different practices
	Multidisciplinary management	Scherpbier et al. (2013) [32]	Shared care between nurse practitioners and GPs (with access to nephrologist or nephrology nurse via digital technology)	Education to both groups	164	Holland	Decreased BP and serum PTH, increased use of ACEi and statins	Limited supporting data for evaluation
		Barrett et al. (2011) [25]	Nurse co-ordinated care (with access to nephrologist)		427	Canada	No difference in rate of decline of eGFR or BP. But an increase in mean eGFR	Most patients ‘extremely satisfied’ with care on questionnaire
		Bayliss et al. (2011) [27]	MDT approach (including nephrologist, pharmacy specialist, diabetes educator, dietitian, social worker, and nephrology nurse)	Components included weekly meetings, contact by telephone or email, individualised plans and patient education	2002	USA	Rate of decline of eGFR improved. No differences in BP, lipids or HbA1C	Limited data to determine which individual components were effectual
		Richards et al. (2008) [33]	Disease management programme (includes patient education, medication review, dietetic advice and social worker)	Desktop guide for clinicians containing clinical management and referral algorithms	483	UK	Improved eGFR, BP and cholesterol.	An extra resource. 85 % enrolment of practices within one area
		Patel et al. (2005) [45]	Pharmacists performing medication reviews		82	USA	Improvement of CKD recognition. No difference in BP, HbA1C or creatinine clearance	99 % of patients had prescription related problems. Only 40.9 % of advice was accepted
	Computer software	Drawz et al. (2012) [36]	Access and training for CKD registries	Educational lecture to both groups, academic detailing	781	USA	Increased PTH measurements, but no difference in BP control	Poor uptake: only 5/37 GPs accessed the registry
		Erler et al. (2012) [35]	Medication alert software with training	1 h education to both groups, patient info leaflets	404	Germany	Improved prescribing	Lack of contextual integration limited its use
		Abdel Kader et al. (2011) [23]	Computer-generated automatic alerts for referral to nephrologist	Two 15 min educational sessions for GPs in both groups	248	USA	No differences in referral to nephrologists or BP control	97 % uptake rate of GPs. No dropouts from study
		Fox et al. (2008) [30]	Computer decision support software generating a recommended to-do list	Ancillary staff + monthly academic detailing	180	USA	Mean eGFR, CKD recognition, anaemia diagnosis all improved	Ancillary staff also did extra work including translating patient guides
	Financial	Karunaratne et al. (2013) [29]	National pay for performance scheme (Quality and Outcomes Framework)		10,040	UK	Improved BP control, increased use of ACEi	High level buy-in generated engagement
CKD interventions aimed at patients	Patient education	Blakeman et al. (2014) [39]	Patient guidebook, telephone guided help from a lay health worker	Booklet and website linking to community resources	436	UK	Improved BP control, increased QALYs	85.7 % uptake rate
		Thomas et al. (2013) [38]	Leaflet, DVD, self-monitoring diary	Single practitioner education and shadowing session	116	UK	Decreased BP	Limited data on level of implementation
		Thomas et al. (2014) [37]	Group education session, leaflet, DVD	Practice training and monthly teleconferences. Patient advisory group	671	UK	Moderate decreases in BP	Patient advisory group involved in design, grant application, delivering education and feedback
	Other	Cottrell et al. (2012) [44]	Mobile phone text messaging BP service		124	UK	No changes in BP, improved prescribing	Many more BP readings

Abbreviations: GP general practitioner, eGFR estimated glomerular filtration rate, BP blood pressure, CKD chronic kidney disease, ACEi angiotensin-converting-enzyme inhibitor, PTH parathyroid hormone, HbA1C glycated haemoglobin, QALYs quality-adjusted life years