Table 1.
Characteristics of Studies Included in the Systematic Review
| Study | Participants Characteristics | Age | Intervention Format and Delivery | Type of Intervention | Framework | Comparator | Primary Outcomes | Study Duration | Country | Sample size |
|---|---|---|---|---|---|---|---|---|---|---|
| Meuleman 2017 [47] | CKD1–4(GFR ≥ 20)/Hypertension | 55.6 ± 11.7i; 54.7 ± 16.0c | Sodium restriction; Delivered by health psychologists and dietician | Lifestyle modifications; Face-to-face |
Coventry, Aberdeen and London Refined (CALO-RE) taxonomy | Usual care | Sodium intake and BP | 38 mo | NED | 67i, 71c |
| Rossi 2014 [48] | CKD3–4(GFR 15–59) | 67.76 ± 12.4i; 69.26 ± 12.4c | Renal rehabilitation exercise; Delivered by exercise physiologist and physical therapist | Lifestyle modifications; Face-to-face |
Usual care | Physical Function Testing, QoL | 3 mo | US | 59i, 48c |
|
| Teng 2013 [49] | CKD1–3 | 63.85 ± 12.78 | Lifestyle Modification Program; Delivered by clinics’ case managers |
lifestyle modifications; Face-to-face |
Trans-Theoretical Model (TTM) | Usual care | Diet modification, Exercise | 12 mo | Taiwan | 52i, 51c |
| Mustata 2011 [50] | CKD3–4(GFR15–60) | 72.5 (59, 79)i; 64 (55, 73)c |
Exercise; Delivered by physical therapist |
Lifestyle modifications; Face-to-face |
Usual care | Physical impairment | 12 mo | CAN | 10i, 10c |
|
| Campbell 2008 [51] | CKD4–5(GFR<30) | 69.75 ± 12.15; | Individualized nutritional counseling: providing individualized nutritional counseling (once every 2 weeks), telephone counseling, and self-management principles; Delivered by dietitian | Lifestyle modifications; Telehealth |
Usual care | SF-36, SGA | 3 mo | AUS | 23i, 24c |
|
| Flesher 2011 [52] | CKD3–4(GFR 20–60)/Hypertension | 63.4 ± 12.1i; 63.4 ± 11.8c | Cooking and exercise programs; Delivered by certified exercise physiologist (CEP), nurse, dietitian, cook educator and exercise physiologist |
Lifestyle modifications; Face-to-face |
Stanford Patient Education | Usual care | CV risk factors, progression of CKD, self-efficacy & self-management | 12 mo | CAN | 23i, 17c |
| Leehey 2009 [53] | CKD2–4/Diabetes & obesity | 66 (range 55–81) | Aerobic exercise | Lifestyle modifications; Face-to-face |
Usual care | Proteinuria | 6 mo | US | 7i, 4c |
|
| Mekki 2010 [54] | CKD2 | 61 ± 14 | Mediterranean diet | Lifestyle modifications; Face-to-face |
Usual care | Lipids and apolipoproteins | 3 mo | ALG | 20i, 20c |
|
| Howden 2015 [55] | CKD3–4(GFR 25–60)/CVD | 60.2 ± 9.7i; 62.0 ± 8.4c | Exercise training and lifestyle program; Delivered by nurse practitioner, exercise physiologist, dietitian, psychologist, credentialed diabetes educator and social worker |
Lifestyle modifications; Face-to-face |
Usual care | Efficacy, Adherence and Safety | 12 mo | AUS | 36i, 36c |
|
| Byrne 2011 [56] | CKD1–4(GFR < 90)/Hypertension | 62.8 ± 11.8 | Evidence-based structured group educational intervention (CHEERS); Delivered by nurse | Medical-behavior modifications; Face-to-face |
Usual care | Recruitment, uptake of the intervention and patient satisfaction | 6mo | UK | 40i, 41c |
|
| van Zuilen 2011 [57] | CKD2–4(GFR 20–70) | 58.9 ± 13.1i; 59.3 ± 12.8c | Nurse practitioner (NP) care; Delivered by nephrologist |
Medical-behavior modifications; Face-to-face |
Usual care | Composite nonfatal myocardial infarction, stroke and cardiovascular mortality | 60 mo | NED | 352i, 346c |
|
| Hotu 2010 [58] | DN(> 0.5 g proteinuria/24 h and Scr 130-300umol/L)& Hypertension | 60 ± 7.1c; 63 ± 6.6i |
community visi t(medication adherence and BP control) Delivered by healthcare assistant | Medical-behavior modifications; Face-to-face |
Usual care | Change in BP. | 4.5 mo | NZ | 30i, 28c |
|
| Williams 2012b [59] | CKD2–4/T1/T2DM&CVD | 74.31 ± 8.37 | multifactorial intervention designed to improve medication self-efficacy and adherence; Delivered by nurse | Medical-behavior modifications; Face-to-face & Telehealth |
Health Belief Model (HBM) | Usual care | Medication self-efficacy & adherence | 12 mo | AUS | 24i, 24c |
| Joboshi 2017 [60] | CKD1–5 | 67 ± 11.5i; 70.1 ± 11.1c |
Participants’ behavioral targets included blood pressure management, medication management, and nutritional management of salt and potassium intakes; Delivered by nurse | Multifactorial modifications; Face-to-face |
Usual care | Self-efficacy and self-management behavior | 3 mo | JPN | 32i, 29c |
|
| Ishani 2016 [61] | CKD3–5(GFR < 60) | 75.1 ± 8.1 | Telehealth and interprofessional case management (BP, volume status, proteinuria, diabetes mellitus, lipid levels, and depression; health literacy and patient activation); Delivered by nephrologist, nurse practitioner, nurses, clinical pharmacy specialist, psychologist, social worker, telehealth care technician and dietician |
Multifactorial modifications; Telehealth |
Components of the chronic care model(CCM). | Usual care | Death, hospitalization, emergency department visits, or admission to skilled nursing facilities | 4.5 mo | US | 450i, 150c |
| Steed 2005 [62] | CKD1–5/T2DM and microalbuminuria | 59.2 ± 8.8i; 60.3 ± 8.6c | Diabetes self-management and developing problem solving techniques (self-monitoring of blood glucose, diet, exercise and medication) Delivered by diabetes nurse, dietician |
Multifactorial modifications; Face-to-face |
Usual care | QoL | 3 mo | UK | 59i, 65c |
|
| Williams 2012a [63] | CKD3–5/Diabetes | 68 ± 8.3i; 66 ± 10.8c | BP & medication adherence; Delivered by renal specialist nurse |
Multifactorial modifications; Face-to-face & Telehealth |
Health Belief Model (HBM) | Usual care | BP control, medication adherence | 12 mo | AUS | 36i, 39c |
| Chan 2009 [64] | Scr 150-350umol/l /T2DM | 65 ± 7.2 | Treatment compliance and self-care (drug use, insulin injection, self-monitoring of blood glucose, and lifestyle modification); Delivered by dietitian and doctor-nurse team |
Multifactorial modifications; Face-to-face | Usual care | Death and/or renal end point (Cr > 500umol/L) | 24 mo | HK | 81i, 82c |
|
| Chen 2011 [65] | CKD3–5 | 68.39 ± 12.08 | Interactive individualized education sessions; Delivered by CKD nursing specialists |
Multifactorial modifications; Face-to-face & Telehealth |
SMS program | Usual care | Improved GFR, No. ofhospitalizations | 12 mo | Taiwan | 27i, 27c |
AUS Australia, US United States, GCG Greater China Group (Mainland China, Hong Kong, Macau and Taiwan), CAN Canada, NED Netherlands, UK United Kingdom, ALG Algeria, NZ New Zealand, JPN Japan
T1DM Type 1 Diabetes, T2DM Type 2 Diabetes, Mo Months
Lifestyle modification, targeting nutrition management, weight management or physical exercise; Medical-behavior modification, targeting medicine adherence, disease cognition and complication control; Multi-factorial modifications, combine lifestyle and medical behavior;
Iintervention; cControl group