‘Self-Management Intervention through Lifestyle Education for Kidney health’ (the SMILE-K study): protocol for a single-blind longitudinal randomised controlled trial with nested pilot study

• Published in: BMJ open 2022-11, Vol.12 (11), p.e064916
• Main Authors: Lightfoot, Courtney J, Wilkinson, Thomas J, Yates, Thomas, Davies, Melanie J, Smith, Alice C
• Format: Article
• Language: English
• Subjects: Behavior; Blood pressure; chronic renal failure; clinical trials; Coronaviruses; COVID-19; Diabetes; Exercise; Feasibility Studies; Humans; Intervention; Kidney; Kidney diseases; Life Style; Lifestyles; Pandemics; Patient education; Physical fitness; Pilot Projects; Primary care; protocols & guidelines; Quality of Life; Randomized Controlled Trials as Topic; Renal Insufficiency, Chronic - therapy; Renal Medicine; Self-Management - methods
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-064916

IntroductionMany people living with chronic kidney disease (CKD) are expected to self-manage their condition. Patient activation is the term given to describe the knowledge, skills and confidence a person has in managing their own health and is closely related to the engagement in preventive health behaviours. Self-management interventions have the potential to improve remote disease management and health outcomes. We are testing an evidence-based and theory-based digital self-management structured 10-week programme developed for peoples with CKD called ‘My Kidneys & Me’. The primary aim of the study (Self-Management Intervention through Lifestyle Education for Kidney health (SMILE-K)) is to assess the effect on patient activation levels.Methods and analysisA single-blind randomised controlled trial (RCT) with a nested pilot study will assess the feasibility of the intervention and study design before continuation to a full RCT. Individuals aged 18 years or older, with established CKD stage 3–4 (eGFR of 15–59 mL/min/1.73 m2) will be recruited through both primary and secondary care pathways. Participants will be randomised into two groups: intervention group (receive My Kidneys & Me in addition to usual care) and control group (usual care). The primary outcome of the nested pilot study is feasibility and the primary outcome of the full RCT is the Patient Activation Measu (PAM-13). The full RCT will assess the effect of the programme on online self-reported outcomes which will be assessed at baseline, after 10 weeks, and then after 20 weeks in both groups. A total sample size of N=432 participants are required based on a 2:1 randomisation. A substudy will measure physiological changes (eg, muscle mass, physical function) and patient experience (qualitative semi-structured interviews).Ethics and disseminationThis study was fully approved by the Research Ethics Committee-Leicester South on the 19 November 2020 (reference: 17/EM/0357). All participants are required to provide informed consent obtained online. The results are expected to be published in scientific journals and presented at clinical research conferences. This is protocol version 1.0 dated 27 January 2021.Trial registration numberISRCTN18314195.