Controlling Hypertension: Education & Empowerment Renal Study (C.H.E.E.R.S)

The overall aim of the programme of work in this thesis was to contribute to the development of effective patient education for BP control in people with chronic kidney disease (CKD). Specific objectives of the thesis were: 1. To define the problem of BP control in our local CKD population by conducting a cross-sectional investigation. 2. To conduct a systematic review of randomised controlled trials (RCTs) evaluating educational interventions in kidney disease care, in order to establish the effectiveness of patient education based on patient empowerment and to set out key recommendations for the development and evaluation of good quality educational interventions. 3. To develop a structured educational intervention designed to be realistic and practical within the context of a busy renal department involving: a. identification of suitable theories and evidence and b. identification and exploration of patients’ and health professionals’ needs regarding BP control, using focus groups. 4. To test the hypothesis that implementation of an educational intervention would lead to improved BP control, by conducting an exploratory RCT comparing standard clinical care for BP management with standard care supplemented by the educational intervention. Key findings showed: • A need for education with less than half our CKD population with BP to target. • Limited evidence is available evaluating the effectiveness of patient education in kidney disease care and the current literature lacks rigorous study design and reporting. • Patient confusion is a key issue that needs to be addressed. • The effective delivery and evaluation of education to promote BP control in people with CKD requires increased patient awareness and involvement. The findings from this programme of research are used to provide evidence for recommendations to improve future research and clinical management to promote better BP control in people with CKD.