Blair, Carolyn, Slee, Adrian, Davenport, Andrew, Fouque, Denis, Johnston, William, Kalantar-Zadeh, Kamyar ORCID: 0000-0002-8666-0725, Maxwell, Peter ORCID: 0000-0002-6110-7253, McKeaveney, Clare, Mullan, Robert, Noble, Helen ORCID: 0000-0002-5190-8399, Porter, Sam, Seres, David, Shields, Joanne, Swaine, Ian ORCID: 0000-0002-3747-1370, Witham, Miles and Reid, Joanne ORCID: 0000-0001-5820-862X (2022) Developing an evidence and theory based multimodal integrative intervention for the management of renal cachexia: a theory of change. Healthcare, 10 (12):2344. pp. 1-25. ISSN 2227-9032 (Online) (doi:https://doi.org/10.3390/healthcare10122344)

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Abstract

In this study, we aimed to develop a theoretical framework for a multimodal, integrative, exercise, anti-inflammatory and dietary counselling (MMIEAD) intervention for those with renal cachexia with reference to how it addresses the underlying causal pathways for renal cachexia, the outcomes anticipated, and how these will be evaluated. We used a Theory of Change (ToC) approach to guide six steps. Step 1 included inputs from a workshop to obtain key stakeholder views on the potential development of a multimodal intervention for renal cachexia. Step 2 included the findings of a mixed-methods study with Health Care Practitioners (HCPs) caring for individuals with End Stage Kidney Disease (ESKD) and cachexia. Step 3 included the results from our systematic literature review on multimodal interventions for cachexia management. In step 4, we used the body of our research team’s cachexia research and wider relevant research to gather evidence on the specific components of the multimodal intervention and hypothesised causal pathways for renal cachexia. In steps 5 and 6 we developed and refined the ToC map in consultation with the core research team and key stakeholders which illustrates how the intervention components of MMIEAD interact to achieve the intended impact of improved functionality and quality of life and reduced premature mortality. The results of this study provide a theoretical framework for the forthcoming MMIEAD intervention for those with renal cachexia and in subsequent phases will be used to determine whether the intervention is effective. To the best of our knowledge no other multimodal intervention trials for cachexia management have reported a ToC for their intervention. Therefore, this research may provide a useful contribution to the ongoing development of interventions for cachexia management.

Item Type:	Article
Uncontrolled Keywords:	cachexia; kidney disease; renal disease; end-stage kidney disease; theory of change; personal and public involvement; complex intervention; multimodal intervention
Subjects:	H Social Sciences > HD Industries. Land use. Labor > HD61 Risk Management R Medicine > RB Pathology R Medicine > RT Nursing
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified:	07 Jul 2023 15:14
URI:	http://gala.gre.ac.uk/id/eprint/38079

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