Effect of Self-management Intervention on Improvement of Quality of Life in Chronic Kidney Disease Patients: A Scoping Review

Chronic Kidney Disease (CKD) presents significant challenges globally, affecting health-related outcomes, quality of life (QoL), and healthcare expenditure. Self-management interventions are currently gaining importance as a means to empower the patients to manage their disease by themselves. However, currently there is a paucity of evidence evaluating its overall and proven role in patients with CKD. With this goal, we have designed this review to have a consensus on this aspect.

The objective of this study is to determine the effect of self-management interventions among patients with CKD who are not on renal replacement therapy (RRT).

This review was performed complying with the guideline set by the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR). Literature search was conducted using PubMed, Scopus, and ProQuest databases using the keywords “Chronic Kidney Disease”, “self-management intervention” and “Quality of Life”. Articles on patients with CKD not requiring RRT, published between January 2018 and December 2023, were included in this review. Articles such as dissertations, review articles, non-interventional studies, and those written in languages other than English were excluded. Out of the initially screened 17, 279 studies, 23 studies (including 3, 345 patients aged between 18 and 81 years) fulfilled our inclusion criteria were finally included in this review. Quality assessment and data extraction were conducted using Critical Appraisal Skills Program (CASP) and Mixed Method Appraisal tool (MMAT).

Overall use of self-management interventions led to improvements in diet quality, psychological health, Health Related Quality of Life (HRQoL), self-management behaviors, and physiological and biochemical markers in patients with CKD. Nurse-led interventions, multidisciplinary approaches, and virtual care were found to be effective in enhancing self-efficacy and QoL.

Self-management interventions can significantly improve various aspects of health and QoL in CKD patients. Nurse-led and multidisciplinary approaches, as well as virtual care, are found to be effective strategies in this subset of patients who do not require RRT. Further research is needed to emphasize evidence and refine the interventions for broader application.