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Background <p>Currently there is insufficient evidence to inform the co-design of an exercise intervention as part of a multimodal intervention for renal cachexia. Co-design is an effective approach in collaborating with service users, carers and healthcare professionals to identify acceptable methods of improving delivery of care. The aim of this study was to use a co-design process to adapt an exercise intervention for patients with or at risk of renal cachexia as part of a cRCT for a multimodal intervention (NCT07107087)</p> Methods <p>The objectives were as follows: (1) To co-design a strategy to promote optimal recruitment and adherence to an exercise intervention for those with or at risk of renal cachexia receiving HD, (2) To produce a conceptual model in relation to the implementation of an exercise intervention for this group. Using Bird and colleagues generative co-design framework for healthcare innovation, we adopted three stages of pre-design, co-design, and post-design. Accordingly, three workshops were conducted to correspond to each stage and the operational decisions recorded in seven steps to report the iterative design of the exercise intervention. The co-design workshops took place in November 2023 (<i>n</i> = 10), June 2024 (<i>n</i> = 11) and February 2025 (<i>n</i> = 6). Public co-design partners from Northern Ireland and England representing Kidney Care UK, Northern Ireland Kidney Patients Association and Northern Ireland Kidney Research Fund, participated in the workshops.</p> Results <p>Contexts, intervention factors, mechanisms and outcomes which influence the uptake of, and adherence to, an exercise intervention within this patient population were identified. These included: the exercise intervention with an individualised and flexible approach; ensuring the exercise programme is manageable for patients receiving HD (session duration, timing and fistula awareness); ensuring the content of the exercise booklets is relatable and achievable (using household items rather than traditional exercise equipment and accrediting everyday activities as part of exercise log); providing support during the intervention (weekly telephone calls and progress tracking); and invitation to patients receiving HD considered most promising to encourage recruitment, sustain involvement and maximise impact from trusted healthcare professionals.</p> Conclusion <p>Using the generative co-design framework for healthcare innovation, a conceptual model has been produced to promote optimal recruitment and adherence to an exercise intervention as part of a multimodal intervention for renal cachexia management in practice. This has informed component design, the wider implementation plan and evaluation design of a multimodal intervention for renal cachexia.</p>

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Using a generative co-design framework to adapt an exercise intervention as part of a multimodal intervention for patients’ receiving haemodialysis with or at risk of renal cachexia

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  • 发表日期：

    2026年4月17日

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  • Carolyn Blair,
  • Adrian Slee,
  • Clare McKeaveney,
  • Alexander P. Maxwell,
  • Faizan Awan,
  • Malcolm Brown,
  • Marion Carson,
  • Sinead Comer,
  • Andrew Davenport,
  • Damian Fogarty,
  • Denis Fouque,
  • Oonagh Gooding,
  • Teresa McKinley,
  • Carolyn Hutchinson,
  • Kamyar Kalantar-Zadeh,
  • Karen Magee,
  • Neal Morgan,
  • Robert Mullan,
  • Helen Noble,
  • Sam Porter,
  • David S. Seres,
  • Joanne Shields,
  • Ian Swaine,
  • Miles D. Witham,
  • Joanne Reid

摘要

Background

Currently there is insufficient evidence to inform the co-design of an exercise intervention as part of a multimodal intervention for renal cachexia. Co-design is an effective approach in collaborating with service users, carers and healthcare professionals to identify acceptable methods of improving delivery of care. The aim of this study was to use a co-design process to adapt an exercise intervention for patients with or at risk of renal cachexia as part of a cRCT for a multimodal intervention (NCT07107087)

Methods

The objectives were as follows: (1) To co-design a strategy to promote optimal recruitment and adherence to an exercise intervention for those with or at risk of renal cachexia receiving HD, (2) To produce a conceptual model in relation to the implementation of an exercise intervention for this group. Using Bird and colleagues generative co-design framework for healthcare innovation, we adopted three stages of pre-design, co-design, and post-design. Accordingly, three workshops were conducted to correspond to each stage and the operational decisions recorded in seven steps to report the iterative design of the exercise intervention. The co-design workshops took place in November 2023 (n = 10), June 2024 (n = 11) and February 2025 (n = 6). Public co-design partners from Northern Ireland and England representing Kidney Care UK, Northern Ireland Kidney Patients Association and Northern Ireland Kidney Research Fund, participated in the workshops.

Results

Contexts, intervention factors, mechanisms and outcomes which influence the uptake of, and adherence to, an exercise intervention within this patient population were identified. These included: the exercise intervention with an individualised and flexible approach; ensuring the exercise programme is manageable for patients receiving HD (session duration, timing and fistula awareness); ensuring the content of the exercise booklets is relatable and achievable (using household items rather than traditional exercise equipment and accrediting everyday activities as part of exercise log); providing support during the intervention (weekly telephone calls and progress tracking); and invitation to patients receiving HD considered most promising to encourage recruitment, sustain involvement and maximise impact from trusted healthcare professionals.

Conclusion

Using the generative co-design framework for healthcare innovation, a conceptual model has been produced to promote optimal recruitment and adherence to an exercise intervention as part of a multimodal intervention for renal cachexia management in practice. This has informed component design, the wider implementation plan and evaluation design of a multimodal intervention for renal cachexia.