Rachel Reilly|Katharine Evans|Judith Streak Gomersall|Gillian Gorham|Micah D J Peters|Steven F. Warren|Rebekah O’Shea|Alan Cass|Alex Brown
Effectiveness, cost effectiveness, acceptability and implementation barriers/enablers of chronic kidney disease management programs for Indigenous people in Australia, New Zealand and Canada: a systematic review of mixed evidence
South Australian Health and Medical Research Institute|Menzies School of Health Research|South Australian Health and Medical Research Institute|Menzies School of Health Research|University of Adelaide|Baker Heart and Diabetes Institute|South Australian Health and Medical Research Institute|Menzies School of Health Research|South Australian Health and Medical Research Institute
indigenous peoples australia new zealand canada carry greater burden chronic kidney disease ckd general populations country burden predicted increase given human economic cost dialysis understanding better manage ckd earlier stages disease progression important priority practitioners policymakers systematic review mixed evidence undertaken examine evidence relating effectivness costeffectiveness acceptability chronic kidney disease management programs designed indigenous people well barriers enablers implementation programs published unpublished studies reporting quantitative qualitative data health sectorled management programs models care explicitly designed manage slow progression otherwise improve lives indigenous people ckd published 2000 2014 considered inclusion data clinical effectiveness ability selfmanage quality life acceptability cost costbenefit barriers enablers implementation interest quantitative data summarized narrative tabular form qualitative data synthesized using joanna briggs institute metaaggregation approach ten studies included six studies provided evidence clinical effectiveness ckd programs designed indigenous people two provided evidence cost costeffectiveness ckd program two provided qualitative evidence barriers enablers implementation effective andor acceptable ckd management programs common features effective acceptable programs integration within existing services nurseled care intensive followup provision culturallyappropriate education governance structures supporting community ownership robust clinical systems supporting communication central role indigenous health workers given human cost dialysis growing population people living ckd urgent need draw lessons available evidence sources including studies broader population better serve population programs address barriers receiving highquality care improve quality life