A multidisciplinary approach for improving quality of life and self-management in diabetic kidney disease : a crossover study

Helou, Nancy (HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Talhouedec, Dominique (Clinique de La Source, Lausanne, Switzerland) ; Zumstein-Shaha, Maya (Department of Health, Bern University of Applied Sciences, Bern, Switzerland) ; Zanchi, Anne (Service of Nephrology and Hypertension, Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland)

Individuals with diabetic kidney disease are at high risk of complications and challenged to self-manage. Previous research suggested that multidisciplinary approaches would improve health outcomes. This study investigated the effect of a multidisciplinary self-management approach of diabetic kidney disease on quality of life, and self-management, glycemic control, and renal function. A uniform balanced crossover design was used because it attains a high level of statistical power with a lower sample size. A total of 32 participants (aged 67.8 ± 10.8) were randomized into four study arms. In differing sequences, each participant was treated twice with three months of usual care alternated with three months of multidisciplinary management. The intervention improved the present dimension of quality of life demonstrating higher mean rank as compared to usual care (52.49 vs. 41.01; p = 0.026, 95% CI) and three self-care activities, general diet habits, diabetes diet habits, and blood sugar testing (respectively: 55.43 vs. 38.31; p = 0.002, 56.84 vs. 37.02; p = 0.000, 53.84 vs. 39.77; p = 0.008; 95% CI). Antihypertensive medication engagement was high across the study period (Mean = 95.38%, Min = 69%, Max = 100%). Glycemic control and renal function indicators were similar for the intervention and the usual care. Studies are needed to determine how the new recommended therapies for diabetic kidney disease such as SGLT2 inhibitors and GLP-1 receptor agonists impact on self-management and quality of life. View Full-Text


Keywords:
Article Type:
scientifique
Faculty:
Santé
Branch:
Soins infirmiers
School:
HESAV
Institute:
Unité de recherche en santé, HESAV
Date:
2020-07
Pagination:
14 p.
Published in:
Journal of clinical medicine
Numeration (vol. no.):
July 2020, vol. 9, no. 7, Article 2160
DOI:
ISSN:
2077-0383
Appears in Collection:



 Record created 2020-07-17, last modified 2020-10-27

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