Table 4.

Summary of quantitative studies

Study and year (Reference)	Design	Target population	Study size Age (years)	Intervention topic(s)	Provider(s)	Delivery format	Description of intervention	Study outcomes	Study results
RCT
Binik et al (1993)34	RCT	Pre-RRT CKD (creatinine>350 μmol/L and rising rapidly)	204 (E=87, C=92, not part of education=25) Age: 50.2	General CKD knowledge Diet/nutrition Modalities	Trained research assistant	Print Face to face PowerPoint slides	‘Enhanced education’: 22-page booklet Individual slide presentation (75 min) Duration—one session Comparator: standard care	Health status: Duration between session and dialysis initiation—patient in E group survived 4.6 months longer w/o requiring RRT
Gillis et al (1995)35	RCT	CKD 3–5	840 (unclear) Age: NR	Diet/nutrition	Dietician	Print Face to face	‘Modification of diet in renal disease’: ‘Keeping Track’ booklet Monthly meeting with dietician Protein Wise Counter (lists protein content of foods) ‘Shopping Wise’: a guide to convenience and fast foods Visited restaurants and shops Duration—26 months Comparator: standard protein diet	Cognitions: Patient reliance on dietician’s feedback, support and modelling strategies—decreased over time in E group
								Individual outcomes: Top rated interventions by patients—counselling, self-monitoring, protein counter
Devins et al (2003)36	RCT	CKD (creatinine<300 μmol/L and deemed to need RRT in 6–18 months)	297 (E=149, C=148) Age: 58.6	General CKD knowledge Diet/nutrition Medication Modalities Lifestyles	Social worker	Print Face to face Telephone	‘Psychoeducation’: 60-page booklet 90 min interactive educational intervention personalised for each patient Supportive (10 min max) phone calls Q3 weeks Duration—18 months or initiation of RRT Comparator: standard care	Health status: Time to dialysis—E group had 3 month delay in dialysis compared with C group
Devins et al (2005)37	RCT	CKD with progressive reduction in kidney function	335 (E=172, C=163) Age: 47.4–53.9	General CKD Knowledge Diet/nutrition Modalities	Health educator	Print Face to face PowerPoint slides	‘Psychoeducation session’: 22-page booklet Individual slide presentation (60–75 min long) Duration—one visit Comparator: standard care	Health status: Survival predialysis and after dialysis initiation—significantly longer in the E group (2.25 years and 8 months, respectively)
Campbell et al (2008)38	RCT	CKD 4–5	47 (E=24, C=23) Age: 68.5–72.6	Diet/nutrition Other (ie, self-management principles)	Dietician	Face to face Telephone	‘Individual nutritional counselling’: Initial individual consultation with dietician Then phone follow-up Q2 weeks x 1 month then Q1 month Duration: 12 weeks Comparator: standard care	Individual outcomes: QOL—many components of KDQOLSF V.1.3 improved: CKD symptoms, cognitive function, vitality
								Physiological measures: Nutritional assessment PG-SGA—in E group those who were malnourished at baseline improved, in C group malnourished from 12.5%–25%
Byrne et al (2011)26	RCT	CKD 1–4+HTN	81 (E=40, C=41) Age: 62.8–65.4	Comorbidities (ie, HTN management)	Nurse	Print Face to face Telephone	‘Structured education session’: Leaflet on HTN management CHEERS patient education intervention and standard care 2.5-hour group session Phone support from nurse Duration: one session Comparator: standard care	Intervention specific: Feasibility (recruitment, retention, patient satisfaction, patient access of additional support)—findings suggest delivering/evaluating an effective structured group educational intervention to promote better BP control would be challenging
Chen et al (2011)39	RCT	CKD 3–5	54 (E=27, C=27) Age: 68.2	General CKD knowledge Diet/nutrition Medication Lifestyle Modality information for stage IV	Nurse, dietician, nephrologist, peers, volunteers	Print Face to face Telephone	‘Self-management Support’: Individual monthly health education Weekly telephone based support Aid of support group twice monthly (5–10 patients) Duration: 12 months Comparator: standard care	Physiological measures: eGFR change—higher in E group eGFR reduction of >50% less in E group ESRD requiring RRT and all-cause mortality—no significant difference between groups
								Health status: # of hospitalisations in 1 year of follow-up—less in E group
Flesher et al (2011)40	RCT	CKD 3–4+HTN	40 (E=23, C=17) Age: 63.4	Diet/nutrition Physical activity	Nurse, exercise physiologist, dietician, cook educator	Print Face to face	‘Cooking and exercise class’: Standard care and: Group CKD nutrition class (with dietician and cook educator: 2 hour sessions over 4 weeks) plus one shopping tour led by a dietician CKD cookbook 12-week exercise programme (3 × 1 hour sessions/week) led by a certified exercise physiologist and nurse Duration: 12 weeks Comparator: standard care	Physiological measures: Improvement in 4/5 of the following: urinary protein, total cholesterol, eGFR decline, BP, urinary sodium—was considered a success—61% in E group vs 12% in C group
								Behaviours: SM score—some changes in some components in both groups
Joboshi et al (2012)41	RCT	CKD	31 (E=19, C=12) Age: 69.8	Other	Nurse	Face to face Telephone Email	‘EASE (encourage autonomous self-enrichment) programme’: Nurses listen to what patients have difficulties and discuss how they will try to improve Face to face interview monthly Telephone or email contact every 2 weeks Duration: 12 weeks Comparator: standard care	Cognitions: Self-efficacy
								Behaviours: Medication adherence Adherence to BP and weight measurements Limiting salt intake Alcohol consumption Smoking
								Physiological measures: BP
Williams et al (2012)42	RCT	CKD 2–4 (diabetic kidney disease)+DM+HTN	75 (E=39, C=41) Age: 67	Medication Comorbidities	Nurse	Print Face to face Telephone DVD	‘Multifactorial intervention’: Individual medication review (draw chart) Daily self-monitoring of BP × 3 months 20 min DVD Q2 week motivational interviewing follow-up via phone × 12 weeks to support BP management and optimise medication SM Duration: 12 weeks Comparator: standard care	Physiological measures: BP—no difference between groups
								Behaviours: Medication adherence—no difference between groups
Williams et al (2012)43	RCT	CKD 2–4+DM+ cardiovascular disease	78 (E=40, C=38) Age: 74.31	Medication Comorbidities Other (ie, self-efficacy)	Nurse, interpreter	Print Face to face Telephone PowerPoint slides	‘Self-efficacy Medication Intervention (SEM)’: Individual medication review—chart in English but interpreter wrote on medication boxes in patients language or used symbols Individual slide presentation (20 min) via interpreter (Greek, Italian, Vietnamese) Q2 week motivational interviewing follow-up via phone × 12 weeks Duration: 12 weeks Comparator: standard care	Intervention specific: Attrition rate to assess feasibility of study—high attrition
								Cognitions: Medication self-efficacy—no difference between groups
								Healthcare: Health care utilization—no difference between groups
								Physiological measures: Routine clinical lab surrogate measures—no difference
								Behaviours: Medication adherence—no difference
								Individual outcomes: General well-being—no difference
de Brito-Ashurst et al (2013)44	RCT	CKD 3–5+HTN (BP>130/80) +Bengali population	56 (E=28, C=28) Age: 55.7–60.7	Diet/nutrition	Dietician and Bengali worker	Face to face Telephone	‘Diet advice’: Practical cooking and education sessions in the community facilitated by a Bengali worker Followed by Q2 week phone calls to reinforce advice and set new targets Duration: 6 months Comparator: standard care	Physiological measures: BP—decreased by 8 mm Hg in E group 24 hours urinary salt excretion—decrease in E group eGFR—no difference between groups
Paes-Barreto et al (2013)45	RCT	CKD 3–5	89 (E=43, C=46) Age: 63.4	Diet/nutrition	Dietician	Print Face to face Telephone	‘Nutrition education programme’: Standard dietary counselling AND Education folder with recipes to replace salt with sodium free seasoning blends Individual 15–20 min class Hands on session about protein rich food Hands on session using test tubes with the amount of salt in different foods 4 monthly follow-up visits Telephone call to address any doubts with dietary plan Duration: 4–7 months Comparator: standard care	Behaviours: Reduction in protein intake—decreased Adherence to low protein diet—effective
								Physiological measures: Body composition: waist circumference, body fat, BMI, mid-arm muscle circumference—no change Serum albumin—no change
Blakeman et al (2014)46	RCT	CKD 3	436 (E=215, C=221) Age: 72.1	General CKD knowledge Comorbidities Other (ie, community resources	Lay health worker	Print Website Telephone	‘Information and telephone-guided access to community services’: Kidney Information Guidebook Patient-Led Assessment for Network Support ‘PLANS’ booklet and interactive website—tailored access to community resources Telephone guided help from a lay health worker Duration: 6 months Comparator: standard care	Cognitions: Positive and active engagement in life (heiQ)—no difference between groups
								Physiological measures: BP control—better BP maintenance in E group
								Individual outcomes: Health related QOL (EuroQoL EQ-5D index)—higher in E group
McManus et al (2014)47	RCT	HTN (BP>130/80) +CKD3 or DM or CHD	555 (E=277, C=278) Age: 69.3–69.6	Medication Comorbidities	General practitioner, patient	Print Face to face	‘Self-monitoring of BP and self-titration of medications’: Self-monitoring of BP Self-titration of medications following a 3-step plan designed by general practitioner and patient Duration: 12 months Comparator: standard care	Physiological measures: SBP at 12 months—no difference
								Healthcare: Prescription of antihypertensive medications increased in both groups but greater significance in E group
								Symptom mgmt.: Adverse effects— no significant difference between groups
								Individual outcomes: QOL—no significant difference between groups
Park et al (2014)48	RCT	CKD3+HTN+ African-American	15 Age: 58.7	Other (ie, meditation)	Principle investigator, patient	Face to face Audio recording	‘Mindfulness meditation (MM)’ 14 min of prerecorded guided MM using MP3 player and headphones Duration: one session Comparator: BP education	Physiological measures: BP—decrease in SBP/DBP/ HR/MAP Muscle sympathetic nerve activity—decreased
Howden et al (2015)49	RCT	CKD 3–4 and >1 uncontrolled cardiovascular risk factor	72 (E=36, C=36) Age 60.2–62.0	Physical activity	Nurse practitioner, social worker, exercise physiologist, dietician, psychologist, diabetes educator	Print Face to face	‘Exercise training and lifestyle intervention’: Standard care AND Detailed medical/surgical history taken by nurse practitioner Education about exercising safely: maintaining hydration, signs/symptoms of abnormal response to exercise If diabetic—education on hypoglycaemia Exercise prescription individualised on patient’s comorbid conditions Goal=150 min/week of moderate intensity exercise plus resistance training 8 weeks supervised, then 10 month home based Patients got: exercise ball, resistance training booklet Patients contacted regularly to monitor adherence to training Duration: 12 months Comparator: standard care	Physiological measures: METS—improved 6 min walk distance—improved BMI—improved
Leehey et al (2016)50	RCT	CKD 2–4+DM2+BMI>30+ persistent proteinuria	36 (Exercise+diet = 18, Diet=18) Age: 66	Diet/nutrition Physical activity	Personal trainer	Face to face Telephone	‘Structured exercise programme’: Dietary counselling=baseline nutritional counselling with nine follow-up phone calls (both groups) AND Supervised exercise programme 3× week (60 min cardio plus 25–30 min resistance training) Followed by home exercise phase: 3×/week × 60 min with weekly follow-up phone calls and patient encouraged to meet trainer Q1 month Duration: 12 months Comparator: diet counselling only	Physiological measures: Urine protein to creatinine ratio—no change at 52 weeks Symptom limited and constant work rate treadmill time—significant increase in diet+exercise group at 12 but not 52 weeks Urine albumin to creatinine ratio—no change eGFR—no change Inflammation—no change Endothelial function—no change Body composition—no change
Montoya et al (2016)30	RCT	CKD 4	30 (E=16, C=14) Age: 67.9–68.3	General CKD knowledge Diet/nutrition Medication Modalities Other (ie, putting affairs in order)	Nephrologist, nurse practitioner, dietician, social worker	Print Face to face PowerPoint slides	‘Nurse practitioner facilitated CKD group visit’: Binder with section on individual labs, another section for topics of groups visits Six 1.5–2-hour long monthly group visits of 8 patients (~1/2 had family members with them) Three visits done in conjunction with nephrologist’s examinations (first half=apt, second half=education) three visits=education only Interactive discussion at each visit Slide presentation (30–45 min) Duration: 9 months Comparator: standard care	Cognitions: CKD knowledge—improved in both groups Self-efficacy/disease SM—upward trend in E group
								Individual outcomes: Satisfaction—high
Non-RCT
Robinson et al (1988)51	Obs	CKD	25 Age: NR	General CKD knowledge Diet/nutrition Medication Other (ie, self-care activities Modalities	NR	Face to face	‘Renal Bingo’: Bingo game format/group gaming technique Provision of refreshments & prizes for motivation Refreshments made with dietician consultation, reinforced dietary regimen Duration: one session Comparator: none	Cognitions: Information was gained or reinforced—desirable outcome Met a variety of learning needs—desirable outcome
								Intervention specific: Participation was enjoyed—desirable outcome Interest expressed for repeating the exercise—desirable outcome
Klang et al (1998)52	QE	CKD 4–5	56 (E=28, C=28) Age: 54–58	General CKD knowledge Diet/nutrition Physical activity Modalities Other (ie, psychosocial—impact of CKD on economy, family and social life)	Nurse, physician, social worker, dietician, physiotherapist	Face to face	‘Pre-dialysis patient education’: Four 2-hour sessions of group teaching with a classroom approach Individual support follow-up by nephrology team member Duration: four sessions Comparator: standard care	Individual outcomes: Functional and emotional well-being—better in E group*
Cupisiti et al (2002)53	PP	CKD 3b-5	20 Age: NR	Diet/nutrition	NR	Print	‘Vegetarian diet’: Alternate between animal based conventional low protein diet and a vegetable-based low-protein diet Booklets explaining general guidelines and features of the diet Duration: one session Comparator: conventional protein diet	Individual outcomes: Opinions on diet—90% enjoyed
								Physiological measures: Creatinine—no change Albumin—no change Total protein—no change Lipids—decreased Electrolytes—no change Haematocrit—no change Urinary protein excretion— decreased Urinary urea excretion—decreased Body weight—no change
Gutiérrez Vilaplana et al (2007)57	PP	CKD	24 Age: 64.5	General CKD knowledge Diet/nutrition Modalities Other	Nurse, patient volunteers	Print Face to face PowerPoint slides	‘Education Intervention’ Eight 2-hour classes Didactic and discussion Duration: 6 months Comparator: none	Cognitions: Improvement in knowledge of CKD
								Behaviours: Modified lifestyle, diet
								Intervention specific: Reduction of stress, fear Improvement in therapeutic relationships with healthcare providers, companions and multi- disciplinary team.
Pagels et al (2008)55	Obs	CKD	58 Age: 65	General CKD knowledge	Nurse	Print	A diary to promote disease related knowledge, involvement and self-care ability and to promote cooperation between patient and nurse Duration: 12 months Comparator: none	Cognitions: Participation, self-care and disease related knowledge
								Intervention specific: Use of diary Suitability for teaching purposes
Yen et al (2008)56	PP	CKD 3	66 Age: 67.4	General CKD knowledge Diet/nutrition Physical activity Medication	Nephrologist, nurse, dietician, social worker	Print Face to face Telephone	‘Educational intervention’: Handouts One 150 min workshop Individual consults Q6 month with nurse Phone number provided to participants for questions Desserts recommended by dietician given at workshop for educational purposes, lunch boxes designed by dietician given out at the end of the workshop Duration: 12 months Comparator: none	Cognitions: QOL (WHOQOL-BREF Taiwan version)—global increase Knowledge of renal function protection (checklist made by investigators)—no change
								Physiological measures: Creatinine—no change BUN—no change GFR—no change Body weight—no change Muscle weight—no change % Body fat—no change Waist-to-hip ratio— significant decrease in E group BMI—significant decrease in E group BP—no change
Gutiérrez-Vilaplana et al (2009)54	PP	CKD 4–5	41 Age: 60.56	General CKD knowledge Diet/nutrition Physical activity Modalities Other (ie, psychosocial—impact of CKD family, finances, social life)	Nurse, physician, technician, three expert patients	Print Face to face	‘Teaching group’: Six 2-hour monthly group education sessions Booklet for future reference Duration: 6 months Comparator: none	Cognitions: Anxiety—decreased Fear—more control of fear response Stress—decreased
Wu et al (2009)58	QE	CKD 3–5	573 (E=287, Cohort=286) Age: 63.4	General CKD knowledge Diet/nutrition Medication Lifestyle	Nurse, social worker, dietician, HD/PD patient volunteers, physicians	Face to face	‘Multidisciplinary predialysis education (MPE)’: Individual lectures, content-based on CKD stage Dietary counselling biannually Duration: 12 months Comparator: standard care	Health status: ESRD warranting RRT—13.9% in E group vs 43% in C group All cause mortality—1.7% in E group vs 10.1% in C group
								Healthcare: Hospitalisation—2.8% E group versus 16.4% in C group
Wierdsma et al (2011)59	QE	CKD	54 (E=28, C=26) Age: 55–59	Medication	Nurse practitioner	Face to face Print	‘Motivational interviewing’: Counselling by nurse practitioner (in addition to care by nephrologist) using motivational interviewing Using the ‘Long-Term Medication Behaviour Self-Efficacy Scale (LTMBSES)’—areas with score<5 were identified and then up to five areas (picked by patient) were discussed and solutions and goals were set Duration: 6 months Comparator: standard care	Cognitions: LTMBSES—difference in mean self-efficacy score at post-test
Aguilera Florez et al (2012)60	Obs	CKD	19 Age: 58	General CKD knowledge Diet/nutrition Medication Symptom management Physical activity Modalities Other	Nurse, physiotherapist, dietician, pharmacist, psychologist, coordinators, nephrologist, patient mentors	Face to face	‘Escuela ERCA’: 7 1.5 hour multidisciplinary group education sessions held biweekly Up to 10 patients per group with family members Didactic plus discussion format Duration: not reported Comparator: none	Cognitions: Knowledge Anxiety—increased
								Individual outcomes: Satisfaction in group therapy
Choi et al (2012)61	QE	CKD 1–5	61 (E=31, C=30) Age: 53.93–58.33	General CKD knowledge Diet/nutrition Modalities Other (ie, understanding and compliance with SM)	Physician, nurse, dietician	Face to face PowerPoint slides	‘Face-to-face SM programme’: 90 min lecture with slides (3–5 people/group) 20 min individual consult 1 week later individual reinforcement education and consultation Duration: two sessions Comparator: general maintenance	Cognitions: Knowledge of CKD scale—increase>in E group
								Behaviours: Self-care practice scale for patients with CKD—no difference between E group and C group but did increase over time for both groups
								Physiological measures: BUN/Creatinine—no change Na/K—no change Ca/PO4—no change Haemoglobin—no change GFR—no change
Kao et al (2012)27	QE	CKD 1–4	94 (E=45, C=49) Age: 73.17	General CKD knowledge Physical activity	Instructor	Print Face to face Telephone	‘Exercise education intervention’: Manual 1.5-hour exercise/health education course Drafted exercise contract and exercise programmes Follow-up phone calls 1x/month for patients in maintenance phase 2×/month for patients in action/prep stages 4×/month for patients at precontemplation/contemplation stages Goal: workout 3–5×/week × 30 min for 3 months Duration: 4 months Comparator: standard care	Behaviours: Exercise behaviour—improved in E group
								Cognitions: Depression—score decreased (ie, improved) in E group
								Symptom management: Fatigue—score decreased in E group
Diamantidis et al (2013)62	PP	CKD 3–5	108 Age: 64	Diet/nutrition Medication	Online tool	Website	‘Disease-specific safety information’: Safe kidney care website—patient/family member and provider portals Education modules displayed in circular distribution to avoid prioritisation of topics Duration: not applicable Comparator: none	Intervention specific: First entry into website -<30% of participants entered within 365 days (total follow-up period) Average dwell time on the website—7 min Modules were ranked by frequency of selection—The three most frequently visited pages were ‘Renal function calculator’, ‘Pills to avoid’ and ‘Foods to avoid’
Kazawa et al (2013)31	PP	CKD 3–4 (diabetic nephropathy)	30 Age: 67	Diet/nutrition Medications Physical activity Comorbidities Other (ie, stress management, identify supporters (family) & how they can contribute, goal setting)	Nurse	Print Face to face Telephone Email	‘SM skills programme’: Textbook Daily journal Four 1 hour face-to-face sessions Q2 weeks at outpatient clinic or in home Two 30 min phone or email sessions Q1 month Then Q1 month phone calls Duration: 6 months Comparator: none	Individual outcomes: QOL—self-efficacy and SM behaviours improved
								Physiological measures: Renal function—no change Haemoglobin A1c—decreased postintervention
Lin et al (2013)63	PP	CKD 1-3a	37 Age 67.42	Other (ie, self-regulation/self management topics)	Nurse	Print Face to face Video	‘SM programme’: Self-monitoring workbook 5 week SM programme Weekly 90 min face- to-face group sessions (6–8 patients) CKD SM video about self-regulation Duration: 5 weeks Comparator: none	Cognitions: CKD self-efficacy—increased
								Behaviours: CKD SM— no change
								Physiological measures: Creatinine—marginally significant decrease GFR—remained stable
Murali et al (2013)28	PP	CKD 4	12 Age: 68	Diet/nutrition	Online tool	Website	‘Dietary assessment and evaluation tool’: Self-administered Obtains 24 hours food history Then evaluates diet based on KDOQI GL Then share general tips for success A report is generated for the nephrologist to guide discussion with patients Duration: single exposure Comparator: none	Cognitions: Change in patients’ self-efficacy to adhere to KDOQI GL after single exposure to the tool—three worsened, three improved, six no change
								Intervention specific: Tool acceptability –well accepted Congruence of patient and provider attitudes—incongruence in 4/10 cases where provider states used report but patient doesn’t verify
Nauta et al (2013)32	PP	CKD	22 Age: 55.2–59.8	Diet/nutrition Physical activity Lifestyle	Online tool	Print Website	‘Lifestyle management tool’: 33-page quick start guide provided Patients had access to site for 4 months—patient choice to frequency of visits to website Duration: 4 months Comparator: none	Cognitions: Self-efficacy—limited effectiveness
								Behaviours: SM—limited effectiveness
Thomas and Bryar (2013)33	MM	Diabetic nephropathy (DM+microalbuminuria)	176 (E=116, C=60) Age: NR	General CKD knowledge Comorbidities Lifestyle	NR	Print DVD	‘SM package’: Written materials 20 min DVD Self-monitoring diary Fridge magnet with key messages BP monitor if needed Duration: one session Comparator: standard care	Physiological measures: BP—no statistically sig difference Haemoglobin A1c—no change BMI—no change
Walker et al (2013)64	PP	CKD with high risk of Progression+DM2+HTN + albuminuria	52 Age: 57.5	Diet/nutrition Medication Symptom management Physical activity Other (ie, compliance)	Nurse, nurse practitioner	Print Face to face	‘Nurse practitioner intervention in primary care setting’: SM booklet Initial assessment of lifestyle behaviours, SM practice, health/medication knowledge Individual education Individualised patient management plan given at end of 12 weeks Q2 week 30 min long assessments and review × 12 weeks Duration: 12 weeks Comparator: none	Behaviours: SM (Partners in Health (PIH) instrument)—had change in certain domains
Wright Nunes et al (2013)65	QE	CKD 1–5	556 (E=155, Cohort=401) Age: 57	General CKD knowledge Diet/nutrition Medication Physical activity Lifestyle Comorbidities Other (ie, compliance)	Nephrology fellows	Print Face to face	‘Physician-delivered education too’ 1-page intervention worksheet delivered during clinic visits—take 1–2 min to administer Duration: one session Comparator: ‘historical group’—who developed sheet	Cognitions: Kidney specific knowledge—associated with increase in knowledge
								Intervention specific: Feasibility of intervention—physicians found it useful and efficient but had concern regarding some of the talking points
Walker et al (2014)24	PP	CKD with high risk of Progression+DM2+HTN + albuminuria	52 Age: 57.5	See Walker et al 64	Nurse, nurse practitioner	See Walker et al 64	See Walker et al 64	Physiological measures: Albuminuria—improved GFR—no change 5 year absolute cardiovascular risk—improved BP—improved Total cholesterol—improved Haemoglobin A1c—improved
								Cognitions: Knowledge of medications/conditions improved
								Behaviours: Medication adherence, adherence to healthy lifestyle improved
Enworom et al (2015)66	QE	CKD 1–4	49 (E=25, C=24) Age: 73	General CKD knowledge Symptoms management Modalities Comorbidities Other (ie, advanced care planning)	Nurse practitioner, physician assistants, clinical nurse specialist	Face to face	‘Kidney Disease Education (KDE)’ six education classes on one on one or group basis Duration: unclear Comparator: no KDE	Physiological measures: GFR decline—slower in E group Haemoglobin—E group maintained more stable level compared with non-KDE group who lost 1 g/L from baseline
								Cognitions: Kidney disease knowledge (KiKS survey)—no change
Vann et al (2015)29	PP	CKD 3b-4	9 Age: mean NR	General CKD knowledge Diet/nutrition Symptom management Modalities Comorbidities Other (ie, self-care management strategies and behaviours)	Nurse practitioner	Print Website Face to face White board	‘CKD Education Programme’ CKD education sessions Assessment of readiness to change CKD toolkit individualised for each participant Collaborative goal setting between nurse practitioner and patient Information booklet with websites listed Patients met with nurse practitioner for 60 min Duration: over six visits Comparator: none	Cognitions: CKD-related knowledge—improved
								Behaviours: Self reported behaviour change—improved
Cupisiti et al (2016)67	Obs	CKD 3b-5	823 (E=305, C=518) Age: 69–74	Diet/nutrition	Dietician	Face to face	‘Nutritional Treatment’ Renal dietician assessed dietary habits using 3-day dietary recall & performed an intervention tailored to the needs/clinical features of the patient Progressed from ‘normal’ diet → low protein diet → very low protein diet depending on needs Duration: at least 6 months Comparator: standard care	Physiological measures: Phosphaturia—lower in E group
								Healthcare: Furosemide use—lower in E group Calcium free phosphate bind use—lower in E group ESA use—lower in E group Active vitamin D preparation use—lower in E group
								Individual outcomes: Dietary satisfaction questionnaire—majority of E group patients were satisfied with their die
Ong et al (2016)68	PP	CKD 4–5	45 Age: 59.4	Medications Symptom management Comorbidities Other (ie, tracking lab results)	Mobile application	Smart phone application	‘Smartphone based SM system’ Application generated personalised patient messages based on prebuilt algorithms Duration: 6 months Comparator: none	Physiological measures: BP—change in home BP readings
								Intervention specific: Medications— 127 medication discrepancies identified
Penaloza-Ramos et al (2016)25	Obs	HTN (BP>130/80)+CKD stage three or CVA/TIA or DM or MI or angina or CABG	NR Age: NA	See McManus et al 47	General practitioner, patient	See McManus et al 47	See McManus et al 47	Healthcare: Cost effective—yes

Not applicable.

Outcome improved post intervention.

Outcome worsened post intervention.

Outcome unchanged post intervention.

Outcome had mixed results (some improved and/or some worsened and/or some did not change).

BMI, body mass index; BP, blood pressure; C, control; CALD, culturally and linguistically diverse; CHD, coronary heart disease; CHEERS, Controlling Hypertension: Education and Empowerment Renal Study; CKD, chronic kidney disease; CVA, cerebrovascular accident; DBP, diastolic blood pressure; DM, diabetes mellitus; E, experimental; eGFR, estimated glomerular filtration rate; ESA, erthropoiesis stimulating agents; ESRD, early stage renal disease; HTN, hypertension; MM, mixed methods; NR, not reported; Obs, observational; PP, pre-post intervention; QE, quasi-experimental; QOL, quality of life; RCT, randomised controlled trial; RRT, renal replacement therapy; SBP, systolic blood pressure; SM, self-management; TIA, transient ischaemic attack.