J Med Assoc Thai 2019; 102 (8):30

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The Impact of Self-Management and Case Management on Progression of Chronic Kidney Disease in Urban Communities of Khon Kaen
Kankarn W Mail, Tongkrajai P , Kumphon B , Anutrakulchai S

Objective: This randomized controlled trial was designed to compare the efficacy of self-management and case management compared with conventional care in CKD patients.
Materials and Methods: The study included 200 CKD patients with stages II-IV. They were randomly assigned into intervention and control groups. The intervention group received experience-sharing sessions based on case studies, behavior change, and home visits. The control group received only conventional care and they were followed-up for 12 months. The data clinical outcomes and self-management behavior were collected and analysed using descriptive statistics and independent t-test.
Results: The mean age of participants was 69 years. The mean eGFR was revealed to be 45.90 ml/min/1.73 m2 (stage 3) and the comorbidities were diabetes mellitus with hypertension. The absolute eGFR and self-management behavior mean scores at the end of the study was significantly higher than before intervention and in the control group (49.57 versus 46.23 ml/min/1.73 m2; p<0.05). Furthermore, intervention group had statistically significant lower mean blood pressure compared to the control group (129.58/76.08 versus 135.79/83.59 mmHg). However, BMI, waist circumference and HbA1c were not significantly different
between the two groups.
Conclusion: Self-management and case management play a significant role in reducing CKD progression and improving selfmanagement behavior in CKD patients.

Keywords: Self-management, Case management, Chronic kidney disease


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