Primary care physicians' knowledge and practice patterns in the treatment of chronic kidney disease: An Upstate New York Practice-Based Research Network (UNYNET) study

被引:78
作者
Fox, Chester H.
Brooks, Amanda
Zayas, Luis E.
McClellan, William
Murray, Brian
机构
[1] Univ Buffalo, Dept Family Med, Buffalo, NY 14215 USA
[2] Univ Buffalo, Dept Med & Nephrol, Buffalo, NY 14215 USA
[3] Emory Univ, Dept Med & Nephrol, Atlanta, GA 30322 USA
关键词
D O I
10.3122/jabfm.19.1.54
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: There is a steady increase in the prevalence of chronic kidney disease (CKD) in the United States. Primary care physicians (PCPs) can engage in strategies that are proven to be effective in reducing the progression rate of kidney disease. The National Kidney Foundation has released evidence-based guidelines called the Kidney Disease Outcome Quality Improvement Initiative (K/DOQI) that detail these strategies. No information exists regarding adoption of these guidelines in primary care. Methods: A qualitative study in a practice-based research network (PBRN) was undertaken to explore common PCP practices and knowledge regarding CKD. A typical case sampling strategy was followed. Semi-structured interviews and exit surveys were conducted with 10 PCPs from randomly selected PBRN practices. Three reviewers conducted content analysis using the immersion- crystallization approach. Results: Five general themes emerged as key findings: ( 1) lack of awareness of K/DOQI guidelines; ( 2) Desire for more CKD practice guidance; ( 3) persistence of traditional, less accurate, diagnostic procedure; ( 4) variability in the treatment of complications; and ( 5) uncertainty of timing for referral to a nephrologist. Conclusion: Facing a growing CKD incidence, PCPs can have an impact on preventing its progression and associated complications with increased familiarity of new guidelines.
引用
收藏
页码:54 / 61
页数:8
相关论文
共 30 条
[1]   Achieving K/DOQI laboratory target values for bone and mineral metabolism:: An uphill battle [J].
Al Aly, Z ;
González, EA ;
Martin, KJ ;
Gellens, ME .
AMERICAN JOURNAL OF NEPHROLOGY, 2004, 24 (04) :422-426
[2]  
Anavekar NS, 2004, NEW ENGL J MED, V351, P1285, DOI 10.1056/NEJMoa041365
[3]  
[Anonymous], PRIMARY CARE RES TRA
[4]  
Boos CJ, 2004, MED SCI MONITOR, V10, pSR23
[5]  
BORKAN J, 1999, DOING QUALITATIVE RE, P20
[6]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[7]   Evidence for increased cardiovascular disease risk in patients with chronic kidney disease [J].
Coresh, J ;
Astor, B ;
Sarnak, MJ .
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2004, 13 (01) :73-81
[8]   Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization [J].
Go, AS ;
Chertow, GM ;
Fan, DJ ;
McCulloch, CE ;
Hsu, CY .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (13) :1296-1305
[9]   Treating anemia early in renal failure patients slows the decline of renal function: A randomized controlled trial [J].
Gouva, C ;
Nikolopoulos, P ;
Ioannidis, JPA ;
Siamopoulos, KC .
KIDNEY INTERNATIONAL, 2004, 66 (02) :753-760
[10]   National Kidney Disease Education Program [J].
Hostetter, TH ;
Lising, M .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2003, 14 (07) :S114-S116