Patients’ Experiences and Perspectives of Telehealth Coaching with a Dietitian to Improve Diet Quality in Chronic Kidney Disease: A Qualitative Interview Study

Published:April 09, 2019DOI:



      Dietary behavior change interventions for the self-management of chronic kidney disease (CKD) have the potential to slow disease progression and reduce metabolic complications. Telehealth-delivered dietary interventions may assist in the self-management of CKD, although their acceptability by patients is unknown.


      This study aims to describe the acceptability and experiences of a telehealth coaching intervention that utilized telephone calls and tailored text messages to improve diet quality in patients with stage 3 to 4 CKD.


      Semistructured interview study of adults with CKD.


      Adults with stage 3 to 4 CKD (n=21) aged 28 to 78 (mean 62) years, who completed a 12-week telehealth-delivered dietary intervention in Queensland, Australia, were interviewed from March to July 2017.

      Data analysis

      Interviews were transcribed verbatim and analyzed thematically.


      Five themes were identified: valuing relationships (receiving tangible and perceptible support, building trust and rapport remotely, motivated by accountability, readily responding to a personalized approach, reassured by health professional expertise); appreciating convenience (integrating easily into lifestyle, talking comfortably in a familiar environment, minimizing travel and wait time burden); empowered with actionable knowledge (comprehending diet-disease mechanisms, practical problem solving for sustainable dietary behavior); increasing diet consciousness (learning from recurrent feedback, prompted by reiteration of messages); making sense of complexity (contextualizing and prioritizing comorbidities, gaining confidence to make dietary decisions, setting and achieving realistic goals).


      Among adults with stage 3 to 4 CKD, individualized telehealth coaching for improving diet quality was convenient for patients, and they felt supported and empowered to navigate recommendations and prioritize dietary behavior changes. Telehealth-delivered dietary interventions appear to be well accepted by patients as a way of providing regular, tailored contact with a health professional to support dietary management in CKD.


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      M. M. Warner is accredited practising dietitian, Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia.


      J. T. Kelly is accredited practising dietitian, Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia.


      A. Tong is an associate professor, Sydney School of Public Health, The University of Sydney, Australia, and from the Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia.


      K. L. Campbell is an associate professor, Faculty of Health Science and Medicine, Bond University, Robina, Queensland, Australia, and an associate professor, Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.