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kidney disease quality primary care

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https://www.readbyqxmd.com/read/29142980/effectiveness-of-multifaceted-care-approach-on-adverse-clinical-outcomes-in-nondiabetic-ckd-a-systematic-review-and-meta-analysis
#1
Aminu K Bello, Bilal Qarni, Arian Samimi, Julius Okel, Trish Chatterley, Ikechi G Okpechi, Ben Vandermeer, Branko Braam
Introduction: The risk of major adverse events associated with chronic kidney disease (CKD) could potentially be reduced with effective medical interventions. The impact of multifaceted interventions as compared with usual care in patients with nondiabetic CKD is unclear. We performed a systematic review to analyze the impact of multifaceted interventions on reducing the risk of major adverse events in this population. Methods: Systematic review and meta-analysis...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29084343/uric-acid-lowering-therapies-for-preventing-or-delaying-the-progression-of-chronic-kidney-disease
#2
REVIEW
Anna L Sampson, Richard F Singer, Giles D Walters
BACKGROUND: Non-randomised data have shown a link between hyperuricaemia and the progression or development of chronic kidney disease (CKD). If this is correct, urate lowering therapy might form an important part of chronic kidney disease care, reducing risks for cardiovascular outcomes and end-stage kidney disease. OBJECTIVES: This review aims to study the benefits and harms of uric acid lowering therapy on the progression of CKD and other cardiovascular endpoints...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29081837/new-ways-of-working-delivering-better-care-for-people-with-long-term-conditions
#3
Victoria Tzortziou Brown, Irem Patel, Nicola Thomas, James Tomlinson, Rachel Roberts, Hugh Rayner, Neil Ashman, Sally Hull
BACKGROUND: The cost-effectiveness of the traditional outpatient model for specialist care provision is increasingly being questioned in view of the changing patient needs, workforce challenges and technological advances. SETTING: This report summarises two RCGP London events showcasing new ways of delivering care for long-term conditions. QUESTIONS: What are the alternative approaches to the traditional outpatient model and do they have common themes? What are the challenges and opportunities of these new models of care? METHODS: Presentation of examples of new ways of long-term condition care delivery and round-table facilitative discussion and reflection on the challenges and solutions around service re-design and implementation, the commissioning and funding of new models of care, the facilitation of system-wide learning and the collection of data for evaluation...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29057734/provider-perspectives-on-chronic-kidney-disease-diagnosis-delivery%C3%A2
#4
Hannah Tiu, Angela Fagerlin, Meghan Roney, Ev Kerr, Akinlolu Ojo, Ed Rothman, Julie Wright Nunes
AIMS: Lack of clear provider communication has been suggested as a reason for low patient awareness of their chronic kidney disease (CKD) diagnosis. Using quality improvement methods, we performed one-on-one provider interviews about CKD diagnosis delivery. MATERIALS AND METHODS: Interviews were audio-recorded, transcribed, and examined using mixed methods. We used thematic analysis to code and analyze transcripts, and Fisher's exact test to examine differences comparing nephrologist and primary care provider (PCP) perspectives...
October 23, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#5
Mark McClure, Thomas Jorna, Laura Wilkinson, Joanne Taylor
INTRODUCTION: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006. These two initiatives have had a significant impact on referral patterns to renal services...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28893206/efficacy-of-blood-flow-restriction-exercise-during-dialysis-for-end-stage-kidney-disease-patients-protocol-of-a-randomised-controlled-trial
#6
Matthew J Clarkson, Steve F Fraser, Paul N Bennett, Lawrence P McMahon, Catherine Brumby, Stuart A Warmington
BACKGROUND: Exercise during haemodialysis improves strength and physical function. However, both patients and clinicians are time poor, and current exercise recommendations add an excessive time burden making exercise a rare addition to standard care. Hypothetically, blood flow restriction exercise performed during haemodialysis can provide greater value for time spent exercising, reducing this time burden while producing similar or greater outcomes. This study will explore the efficacy of blood flow restriction exercise for enhancing strength and physical function among haemodialysis patients...
September 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28878150/multimorbidity-in-chronic-conditions-public-primary-care-patients-in-four-greater-mekong-countries
#7
Supa Pengpid, Karl Peltzer
The aim of this study was to explore the prevalence, pattern, and social determinants of chronic conditions multimorbidity among chronic disease primary care patients in four Greater Mekong countries (Cambodia, Myanmar, Thailand, and Vietnam). In a cross-sectional survey, chronic disease patients accessing primary care were recruited if they had been diagnosed with any of 21 chronic conditions in the past 12 months, and were interviewed with a structured questionnaire on anxiety, depression, alcohol use, tobacco use, dietary behaviour, physical activity, and quality of life...
September 6, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28875593/implementing-an-evidence-based-clinical-decision-support-tool-to-improve-the-detection-evaluation-and-referral-patterns-of-adult-chronic-kidney-disease-patients-in-primary-care
#8
Mary E Regan
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) is undertreated and under-recognized in primary care. The majority of primary care providers (PCPs) are not aware or knowledgeable of current CKD guidelines. The purpose of this project was to develop a quality improvement intervention for PCPs through the delivery of evidence-based guidelines at the point of care. METHODS: An evidence-based clinical algorithm was developed in the electronic medical record for providers to access within one organization comprising 11 primary care offices with 80 PCPs...
September 6, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#9
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28789948/burden-of-multiple-chronic-conditions-among-patients-with-urological-cancer
#10
Tullika Garg, Amanda J Young, Korey A Kost, John F Danella, Sharon Larson, Matthew E Nielsen, H Lester Kirchner
PURPOSE: We describe age, multiple chronic condition profiles and health system contact in patients with urological cancer. MATERIALS AND METHODS: Using Geisinger Health System electronic health records we identified adult primary care patients and a subset with at least 1 urology encounter between 2001 and 2015. AHRQ (Agency for Health Care Research and Quality) CCI (Chronic Condition Indicator) and CCS (Clinical Classifications Software) tools were applied to ICD-9 codes to identify chronic conditions...
August 5, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28780553/a-national-surveillance-project-on-chronic-kidney-disease-management-in-canadian-primary-care-a-study-protocol
#11
Aminu K Bello, Paul E Ronksley, Navdeep Tangri, Alexander Singer, Allan Grill, Dorothea Nitsch, John A Queenan, Cliff Lindeman, Boglarka Soos, Elizabeth Freiheit, Delphine Tuot, Dee Mangin, Neil Drummond
INTRODUCTION: Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28779781/vascular-access-should-be-tailored-to-the-patient
#12
REVIEW
Krzysztof Letachowicz, Przemysław Szyber, Tomasz Gołębiowski, Mariusz Kusztal, Waldemar Letachowicz, Wacław Weyde, Jerzy Garcarek, Marian Klinger
A cornerstone of hemodialysis treatment is the creation of a functional and durable dialysis vascular access. Every patient with chronic kidney disease should have a plan of renal replacement therapy and access site protection. Factors having a crucial impact on vascular access selection include age, comorbidity, vessel quality, prognosis, dialysis urgency, and surgeon's preferences. Our medical group have reviewed these factors in our patients and, based on recently published data, developed a clinical decision tree for dialysis access in the chronic kidney disease patient...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28764919/effects-of-higher-quality-of-care-on-initiation-of-long-term-dialysis-in-patients-with-ckd-and-diabetes
#13
Hon-Yen Wu, Shingo Fukuma, Sayaka Shimizu, Edward C Norton, Yu-Kang Tu, Kuan-Yu Hung, Mei-Ru Chen, Kuo-Liong Chien, Shunichi Fukuhara
BACKGROUND: The burden of diabetes-related chronic kidney disease (CKD) on individuals and society is increasing, shifting attention toward improving the quality of care for patients with CKD and diabetes. We assessed the quality of CKD care and its association with long-term dialysis, acute kidney injury (AKI), and death. STUDY DESIGN: Retrospective cohort study (2004-2011). SETTING & PARTICIPANTS: Adults in Taiwan with incident CKD enrolled in the Longitudinal Cohort of Diabetes Patients...
November 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28741051/a-nationwide-prospective-cohort-study-of-patients-with-advanced-chronic-kidney-disease-in-japan-the-reach-j-ckd-cohort-study
#14
Junichi Hoshino, Kei Nagai, Hirayasu Kai, Chie Saito, Yukiko Ito, Koichi Asahi, Masahide Kondo, Kunitoshi Iseki, Chiho Iseki, Hirokazu Okada, Naoki Kashihara, Ichiei Narita, Takashi Wada, Christian Combe, Ronald L Pisoni, Bruce M Robinson, Kunihiro Yamagata
BACKGROUND: Epidemiology and outcomes of Japanese patients with advanced chronic kidney disease (CKD)-an estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m(2)-has remained largely unexamined. METHODS: We conducted a nationwide survey to determine the distribution of Japanese CKD patients, and are conducting a cohort study of these patients. A questionnaire eliciting details about facilities and their CKD practices was sent to all clinics/hospitals with nephrologists...
July 24, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#15
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
September 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28704407/variations-in-achievement-of-evidence-based-high-impact-quality-indicators-in-general-practice-an-observational-study
#16
Thomas A Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy
BACKGROUND: There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected 'big data' in the evaluation of healthcare. We developed a set of evidence-based 'high impact' quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). METHODS: Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89)...
2017: PloS One
https://www.readbyqxmd.com/read/28663062/community-pharmacist-training-and-communication-network-and-drug-related-problems-in-patients-with-ckd-a-multicenter-cluster-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Lyne Lalonde, Patricia Quintana-Bárcena, Anne Lord, Robert Bell, Valérie Clément, Anne-Marie Daigneault, Marie-Ève Legris, Sara Letendre, Marie Mouchbahani, Ghaya Jouini, Joëlle Azar, Élisabeth Martin, Djamal Berbiche, Stephanie Beaulieu, Sébastien Beaunoyer, Émilie Bertin, Marianne Bouvrette, Noémie Charbonneau-Séguin, Jean-François Desrochers, Katherine Desforges, Ariane Dumoulin-Charette, Sébastien Dupuis, Maryame El Bouchikhi, Roxanne Forget, Marianne Guay, Jean-Phillippe Lemieux, Claudia Morin-Bélanger, Isabelle Noël, Stephanie Ricard, Patricia Sauvé, François Ste-Marie Paradis
BACKGROUND: Appropriate training for community pharmacists may improve the quality of medication use. Few studies have reported the impact of such programs on medication management for patients with chronic kidney disease (CKD). STUDY DESIGN: Multicenter, cluster-randomized, controlled trial. SETTING & PARTICIPANTS: Patients with CKD stage 3a, 3b, or 4 from 6 CKD clinics (Quebec, Canada) and their community pharmacies. INTERVENTION: Each cluster (a pharmacy and its patients) was randomly assigned to either ProFiL, a training-and-communication network program, or the control group...
September 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28616249/quality-of-care-for-patients-with-chronic-kidney-disease-in-the-primary-care-setting-a-retrospective-cohort-study-from-ontario-canada
#18
Danielle M Nash, Scott Brimble, Maureen Markle-Reid, Eric McArthur, Karen Tu, Gihad E Nesrallah, Allan Grill, Amit X Garg
BACKGROUND: Patients with chronic kidney disease may not be receiving recommended primary renal care. OBJECTIVE: To use recently established primary care quality indicators for chronic kidney disease to determine the proportion of patients receiving recommended renal care. DESIGN: Retrospective cohort study using administrative data with linked laboratory information. SETTING: The study was conducted in Ontario, Canada, from 2006 to 2012...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28607686/improving-care-for-patients-with-or-at-risk-for-chronic-kidney-disease-using-electronic-medical-record-interventions-a-pragmatic-cluster-randomized-trial-protocol
#19
Danielle M Nash, Noah M Ivers, Jacqueline Young, R Liisa Jaakkimainen, Amit X Garg, Karen Tu
BACKGROUND: Many patients with or at risk for chronic kidney disease (CKD) in the primary care setting are not receiving recommended care. OBJECTIVE: The objective of this study is to determine whether a multifaceted, low-cost intervention compared with usual care improves the care of patients with or at risk for CKD in the primary care setting. DESIGN: A pragmatic cluster-randomized trial, with an embedded qualitative process evaluation, will be conducted...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28558814/approach-to-growth-hormone-therapy-in-children-with-chronic-kidney-disease-varies-across-north-america-the-midwest-pediatric-nephrology-consortium-report
#20
Oleh M Akchurin, Amy J Kogon, Juhi Kumar, Christine B Sethna, Hoda T Hammad, Paul J Christos, John D Mahan, Larry A Greenbaum, Robert Woroniecki
BACKGROUND: Growth impairment remains common in children with chronic kidney disease (CKD). Available literature indicates low level of recombinant human growth hormone (rhGH) utilization in short children with CKD. Despite efforts at consensus guidelines, lack of high-level evidence continues to complicate rhGH therapy decision-making and the level of practice variability in rhGH treatment by pediatric nephrologists is unknown. METHODS: Cross-sectional online survey electronically distributed to pediatric nephrologists through the Midwest Pediatric Nephrology Consortium and American Society of Pediatric Nephrology...
May 30, 2017: BMC Nephrology
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