Support interventions for caregivers of people with chronic kidney disease: a systematic review

Background. A growing number of patients with chronic kidney disease (CKD) rely on non-professional healthcare providers, such as family and friends, to manage their long-term condition throughout the trajectory of CKD. These informal caregivers can experience stress, depression, lack of confidence and poor quality of life. Yet, the needs of caregivers are often neglected and under-prioritized. The objective of this review is to evaluate the effectiveness of interventions aimed at providing support to caregivers of people with CKD. Methods. We conducted a systematic review of studies that evaluated any intervention for informal caregivers of CKD patients. We searched five electronic databases (up to January Week 5, 2008) including Medline, EMBASE, PsychINFO, CINAHL, Cochrane Central Register and reference lists of relevant articles. Results. Three studies were identified that evaluated an intervention for caregivers of CKD patients. All three only assessed the effect of educational material on caregivers' knowledge. Two evaluated information provided to caregivers of dialysis patients using a pre- and post-test study design. The other study used participatory action research methods to develop and evaluate an information handbook for transplant patients and their caregivers. Studies consistently found that the provision of information improved caregivers' knowledge. No other outcomes were reported. Conclusions. Despite the growing recognition of the burden and adverse effects of CKD on caregivers, no high-quality evidence is available about the effect of information or support interventions on the physical or psychosocial well-being of informal caregivers and the patients. More attention towards the development and evaluation of services that respond to the support and informational needs of caregivers is needed, and this may also lead to improved outcomes for patients.