A CKD awareness campaign and mHealth education to improve knowledge, quality of life, and motivation for a healthy lifestyle among CKD patients in Bangladesh: A randomized controlled trial. (Preprint)

Abstract

Chronic kidney disease (CKD) is linked to major health consequences and a poor quality of life. Despite the fact that CKD is becoming more prevalent, public knowledge of the disease remains low.

The present study aimed to evaluate the outcome of a health education intervention designed to enhance knowledge, health-related quality of life (QOL), and motivation about healthy lifestyle among adults suffering from CKD.

This study was a parallel-group (1:1) randomized controlled trial in the Mirzapur sub-district of Bangladesh that compared two groups of CKD patients. Adults individual with CKD (stages 1-3) were enrolled in November 2020 and randomly assigned to one of two groups: intervention or control. The intervention group received health education through a CKD awareness campaign and mHealth technologies, whereas the control group received standard treatment, and was observed for 6 months. Primary Outcome was evaluation of improved scores on the chronic kidney disease knowledge questionnaire and secondary outcomes were improved QOL and changes in the level of blood pressure (BP), BMI, serum creatinine, fasting blood sugar (FBS), hemoglobin, cholesterol, HDL-c, triglyceride, serum uric acid, blood urea nitrogen, and ACR.

We enrolled 126 patients (control group, n=63, intervention group, n=63) in the study and performed intention to treat analysis. The analyses included repeated measures ANOVA and results were observed to be significantly different in case of within-group (P<.001), between groups (P<.001) and interaction of group × time factor (P<.001) in terms of knowledge score. Diastolic BP and BMI showed significant differences arising from within groups (P<.001, P=.01 respectively) and in interaction of group × time factor (P=.001, P=.02 respectively); food salinity and hip circumferences showed significant difference arising from within groups (P=.001, P=.03 respectively) and between groups (P=.001, P=.02 respectively). Moreover, systolic BP and waist circumference showed significant differences within groups (P<.001, P=.003 respectively). However, no significant differences were found arising from within groups, between groups and interactions of group × time in terms of QOL, urine salinity and MUAC. Regarding laboratory findings, from baseline to six months, the mean (±SD) fasting plasma glucose decreased by 0.51 ± 3.77mg/dl in the intervention group and by 0.10 ± 1.44 g/dl in the control group (P=.03); however, blood urea nitrogen increased by 3.64 ± 7.17 in the intervention group and by 1.68 ± 10.10 g/dl in the control group (P=.01).

The health education strategy, which included a campaign and mHealth, showed promise for enhancing CKD knowledge among CKD patients. This strategy may also aid CKD patients in controlling their fasting blood sugar and blood pressure. The combined health education initiatives give evidence for scaling them up in Bangladesh and possibly other low- and middle-income countries, particularly in rural and peri-urban settings.

ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831.