J KELLY1, M CONLEY2, D REIDLINGER1, T HOFFMANN1, M REEVES3, A TONG4,5, J CRAIG4,5, D JOHNSON6,7,8, S PALMER9, K CAMPBELL1,2
1Faculty of Health Science and Medicine, Bond University, Maudsland, Australia, 2Nutrition and Dietetics Department, Princess Alexandra Hospital, Brisbane, Australia, 3Cancer Prevention Research Centre, School of Public Health, The University of Queensland, Herston, Australia , 4Sydney School of Public Health, The University of Sydney, Sydney, Australia, 5Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, Australia, 6Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia, 7Diamantina Institute, University of Queensland, Brisbane, Australia, 8Translational Research Institute, Brisbane, Australia, 9Department of Medicine, University of Otago, Christchurch, New Zealand
Background: The dietary self-management of CKD is complex and requires regular follow-up to support change.
Aim: To evaluate a six-month telehealth-delivered dietary coaching intervention in stage III-IV chronic kidney disease (CKD).
Methods: To help achieve a diet consistent with the Australian Dietary Guidelines, the intervention group (n=41) received fortnightly dietitian led coaching calls and tailored text messages for three months, then text messages only for another three months. The control group (n=39) received usual care for three months, then non-tailored text messages for three months. Outcomes included feasibility, acceptability, dietary change and clinical parameters.
Results: Retention rates of 93% and 98% were achieved in intervention and control groups, respectively. Ninety-six percent of scheduled intervention calls were completed. All intervention participants identified the tailored text messages as useful in supporting dietary change compared to 69% in the control group. Compared to the control group at three months, the intervention group decreased proportion of energy intake from discretionary foods (intervention effect: -5.3% [CI: -0.6, -9.9]), increased vegetable intake (1.4 serves [0.3, 2.1]), fibre intake (5.5g [2.7, 8.2]), and reduced body weight (-1.7kg [-3.1, -0.3]). At six months, only the intervention effect on discretionary foods remained significant (-4.3% [0.3, 8.2]). There was no significant intervention effect on fruit and sodium intake, waist circumference or blood pressure.
Conclusions: A dietary coaching program is feasible and acceptable for supporting dietary change in stage III-IV CKD. Three months of dietary telehealth coaching improved components of diet quality and decreased body weight, which was attenuated once the control group commenced a text message intervention. Research informing the ideal frequency and degree of telehealth tailoring required to support dietary self-management is warranted.
Jaimon Kelly is an Accredited Practicing Dietitian and PhD Scholar at Bond University. Jaimon is passionate about improving patient-centred care in chronic kidney disease, is an advocate for patient-engagement in both the clinical and research setting, and has a strong interest in exploring new ways to deliver dietary education to improve patient’s self-management.