The Efficacy of a Nurse-Led Disease Management Program in Improving the Quality of Life for Patients with Chronic Kidney Disease: A Meta-Analysis

• Published in: PloS one 2016-05, Vol.11 (5), p.e0155890-e0155890
• Main Authors: Chen, Chong-Cheng, Chen, Yi, Liu, Xia, Wen, Yue, Ma, Deng-Yan, Huang, Yue-Yang, Pu, Li, Diao, Yong-Shu, Yang, Kun
• Format: Article
• Language: English
• Subjects: Anemia; Biology and Life Sciences; Cardiovascular disease; Care and treatment; Chronic illnesses; Chronic kidney failure; Clinical trials; Controlled Clinical Trials as Topic; Demographic aspects; Diagnosis; Dialysis; Disease control; Disease Management; Exercise; Fatigue; Health; Hemodialysis; Hospitals; Identification methods; Kidney diseases; Kidneys; Literature reviews; Medicine and Health Sciences; Meta-analysis; Nephrology; Nurses; Nursing; Pain; Pain perception; Patients; People and Places; Peritoneal dialysis; Peritoneum; Physical Sciences; Practice Patterns, Nurses' - standards; Quality of Life; Renal Insufficiency, Chronic - therapy; Research and Analysis Methods; Sensitivity analysis; Services; Sleep; Studies; Systematic review
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0155890

The impacts of nurse-led disease management programs on the quality of life for patients with chronic kidney disease have not been extensively studied. Furthermore, results of the existing related studies are inconsistent. The focus of the proposed meta-analysis is to evaluate the efficacy of nurse-led disease management programs in improving the quality of life for patients with chronic kidney disease. Literature survey was performed to identify the eligible studies from PubMed, Current Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials with predefined terms. The outcome measured was quality of life. This meta-analysis was conducted in line with recommendations from the preferred reporting items for systematic reviews and meta-analyses. Eight studies comprising a total of 1520 patients were included in this meta-analysis, with 766 patients assigned to the nurse-led disease management program. Nurse-led disease management improved the quality of life in terms of symptoms, sleep, staff encouragement, pain, general health perception, energy/fatigue, overall health and mental component summary when evaluated 6 weeks after the beginning of intervention. When evaluated 12 weeks later, the quality of life in terms of symptoms, sleep, staff encouragement, energy/fatigue, and physical component summary was improved. Stratified by the modalities of dialysis, similar results of pooled analyses were observed for patients with peritoneal dialysis or hemodialysis, compared with the overall analyses. The results of sensitivity analyses were the same as the primary analyses. The symmetric funnel plot suggested that the possibility of potential publication bias was relatively low. Nurse-led disease management program seems effective to improve some parameters of quality of life for patients with chronic kidney disease. However, the seemingly promising results should be cautiously interpreted and generalized and still need to be confirmed through well-designed large-scale prospective randomized controlled trials.