Effectiveness of educational programs for patients with diabetic kidney disease: a systematic review and meta-analysis

Background To prevent the progression of diabetic nephropathy, educational programs to improve self-management are important. However, the effectiveness of educational programs to prevent worsening of diabetic kidney disease on renal function and quality of life is under characterised. Objectives The purpose of this study was to conduct a systematic review and meta-analysis to identify effective educational programs for diabetic kidney disease and the impact of educational programs on improving renal function and quality of life in patients with diabetic kidney disease. Design The study design is a systematic review and meta-analysis. Method We systematically collected research papers, and two authors independently selected papers and evaluated them according to the inclusion criteria. The extracted data were entered into Review Manager 5.4, and the standardised mean difference of the delta estimated glomerular filtration rate (ml/min/1.73m.sup.2/year) was calculated using a random effect size model for the renal function evaluation. Results Overall, 207 articles were retrieved from five electronic databases and three studies were shortlisted. Data from the two studies on delta estimated glomerular filtration rate (ml/min/1.73 m.sup.2/year) were combined, but the results were not significant. The effect on quality of life was observed in only one of the three studies, so they could not be pooled. Conclusions Effective educational programs for self-management of diabetic kidney disease could not be identified because of the small number of studies included. Educational programs reviewed also lacked a significant effect on kidney function, likely related to their short durations. The effect of the education programs on quality of life is unknown because studies could not be pooled. Keywords: Diabetic kidney disease, Educational programs, Estimated glomerular filtration rate, Quality of life, Meta-analysis