169 PATIENT OUTCOMES There were no significant effects on the primary outcomes self-management and patient activation. For the secondary outcomes, we found significant effects (see table 5.2). At T2, the intervention decreased the percentage of patients with hypertension by 14.2%, while in care-as-usual there was an increase of 3.5% (OR=0.45, 95%CI [0.20, 0.99]). The intervention improved the number of lifestyle topics discussed during consultations at T1 (B=0.80, 95%CI [0.28, 1.31] and T2 (B=0.69, 95%CI [0.14 to 1.25]). At T1, the intervention improved outcomes related to the quality of the consultation. For example, 11.8% more intervention patients agreed that the professional listened to their preferred approach, compared to 4.6% less in care-as-usual (OR=2.61, 95%CI [1.05, 6.47]). HEALTH CARE PROFESSIONAL OUTCOMES The intervention effectively improved the self-reported use of health literacy communication strategies at T1 (B=0.64, 95%CI [0.33, 0.95]) and T2 (B=0.56, 95%CI [0.19, 0.93]). It enhanced the use of strategies in gathering information, providing information, shared decision-making, and enabling self-management (see table 5.3). SENSITIVITY AND SUBGROUP ANALYSES The results with the non-imputed dataset and without correction for eGFR were similar to the main analysis (Supplementary files 3 and 4). Subgroup analyses revealed some differences (Supplementary files 5, 6, 7 and 8). For patients at risk, at T2, the intervention tended to positively affect physical activity and fluid intake. For patients with LHL, the intervention effect on hypertension and selfmanagement was similar, but on consultation outcomes weaker. The intervention was more effective in nephrology clinics. For patients who used ≥2 intervention components, effectiveness was higher for consultation outcomes. PROCESS EVALUATION Overall, patients were satisfied. They rated GoYK with 7.75 out of 10 and 97% of the patients considered GoYK comprehensible. 75% used two or three components.
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