34 The first research agenda on CKD and HL[17] and the European HL project IROHLA recommend that, to prevent worse health outcomes, interventions should focus on both patients and professionals[18,19]. State-of-the-art interventions should aim to inform and educate, teach skills, support behavior change, strengthen social and professional support, and facilitate the involvement of individuals at a system level. Preferably, such interventions should be customized to the patient’s specific health context or environment[19]. Although in non-CKD care settings, HL tailored interventions have been found to be effective in improving both patient[20–23] and professional[24] capacities, for CKD it remains uncertain how interventions can most effectively improve health outcomes of LHL patients. This systematic review therefore aims to identify potential targets and strategies by summarizing the evidence on: 1) patient- and system-level factors that potentially mediate the relation between LHL and health outcomes, and 2) the effectiveness of HL-interventions that are customized to CKD patients.
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