Evaluation and implementation planning of an online self-management resource for people with chronic kidney disease: a mixed methods study

People with chronic kidney disease (CKD) face increased health risks, including cardiovascular complications and progression to end-stage kidney disease requiring kidney replacement therapy. Enhancing self-management behaviours is vital to delaying disease progression and improving outcomes. Previously, CKD care in the UK has lacked resources for non-dialysis patients; however, recent efforts have focused on developing supportive tools to address this gap. One such resource, ‘My Kidneys & Me’ (MK&M), offers potential support, but little is known about its adoption and integration into routine healthcare.Aims: This study explored healthcare professionals’ and providers (HCPs) perspectives on CKD self-management and how MK&M could be embedded into clinical workflows. It also identified priority outcomes for CKD self-management and examined MK&M’s use in primary care.Methods:• Qualitative interviews: Semi-structured interviews with HCPs examined barriers, facilitators, and requirements for adopting self-management tools. Thematic analysis was applied.• Delphi survey: A three-round online survey involving patients, caregivers, and professionals identified key CKD self-management outcomes using content and descriptive analysis.• Pilot implementation: MK&M was piloted in a Primary Care Network with people living with CKD stages 3-4. Sociodemographic data, staff surveys, and interviews assessed feasibility and perceptions.Results: Interviews highlighted the need for CKD education and support. Barriers included organisational constraints; enablers involved stakeholder awareness and guidance. The Delphi survey prioritised outcomes in ‘clinical’ and ‘knowledge, skills and confidence’ domains. The pilot showed MK&M could align with existing CKD pathways, though contextual factors must be addressed for broader implementation.Discussion: MK&M shows potential as a self-management support resource for people living with CKD. However, refinements in design and delivery are needed to enhance uptake. This research informs future implementation strategies by highlighting HCP perspectives and key outcome priorities.The original contribution within this thesis includes: understanding kidney professionals' views on self-management in kidney disease; this study was also the first to systematically identify the key outcomes to focus on for self-management; the data showed how an implementation trial could potentially be conducted when the online self-management resource was adopted in clinical practice.