RESEARCH ARTICLE Open Access A need-based approach to self- management education for adults with co-morbid diabetes and chronic kidney disease Edward Zimbudzi 1,2 , Clement Lo 2,4 , Peter G. Kerr 1 and Sophia Zoungas 2,3,4* Abstract Background: Self-management education needs have not been assessed in patients with complex co-morbid conditions such as diabetes and chronic kidney disease (CKD). The objectives of this study were to 1) determine the self-management education needs for patients with co-morbid diabetes and CKD and 2) co-develop an educational resource meeting the self-management education needs of patients with co-morbid diabetes and CKD. Methods: Patients with co-morbid diabetes and CKD attending a co-designed, patient-centred outpatient diabetes and kidney clinic at a tertiary metropolitan hospital were recruited for semi-structured interviews. Maximal variation sampling was used, ensuring adequate representation of different gender, age, diabetes duration and stage of CKD. Data were thematically analysed using grounded theory. Results: Forty-two patients participated. Most were male (67%) and the mean age was 64.8 (11.1) years. The majority of patients preferred an educational resource in the form of a Digital Versatile Disc (DVD) and they thought that current education could be improved. In particular patients wanted further education on 1) management of diabetes and kidney disease (including nutrition and lifestyle, and prevention of the progression of kidney disease) and 2) complications of comorbid diabetes and kidney disease. Conclusion: Patients with co-morbid diabetes and kidney disease have education gaps on the management of, and complications of diabetes and kidney disease. Interventions aimed at improving patient education need to be delivered through education resources co-developed by patients and health staff. A targeted education resource in the form of a DVD, addressing these needs, may potentially close these gaps. Keywords: Diabetes, Chronic kidney disease, self-management education, Patient engagement, Patient-centred care Background The terms ‘ self-management education’ , ‘ self-management support’ and ‘patient education’ are often used inter- changeably especially when describing the management of patients with diabetes. Diabetes self-management educa- tion (DSME) is designed to help patients develop skills and techniques to enhance diabetes self-care [1–3] leading to improved clinical and self-reported outcomes such as health related quality of life [4]. Diabetes self-management support (DSMS) refers to the support that is required for implementing and sustaining coping skills and behaviours needed to self-manage [2, 3]. In contrast, patient education primarily involves increasing a patient’ s knowledge about a disease in order to change behaviour [5]. Self-management education underpinned by self-management support and patient edu- cation are paramount for acquisition of problem-solving skills that empower patients to self-care [6, 7]. Assessment of self-management education needs among patients with chronic diseases such as diabetes [8] and chronic kidney disease (CKD) [9] has indicated a © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. * Correspondence: sophia.zoungas@monash.edu 2 School of Public Health and Preventive Medicine, Monash University, Alfred Centre, 99 Commercial Road, Melbourne 3004, Australia 3 The George Institute for Global Health, University of Sydney, Sydney, Australia Full list of author information is available at the end of the article Zimbudzi et al. BMC Nephrology (2019) 20:113 https://doi.org/10.1186/s12882-019-1296-z