The Impact of Self-Management and Case Management on Progression of Chronic Kidney Disease in Urban Communities of Khon Kaen
Kankarn W, PhD candidate1, Tongkrajai P, PhD1, Kumphon B, PhD2, Anutrakulchai S, MD, PhD3
Affiliation : 1 Faculty of Medicine, Mahasarakham University, Mahasarakham, Thailand 2 Department of Mathematics, Faculty of Science, Mahasarakham University, Mahasarakham, Thailand 3 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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 self-
management behavior in CKD patients.
Keywords : Self-management, Case management, Chronic kidney disease
