A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of...
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| Format: | Article |
| Language: | English |
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Academy of Family Physicians of Malaysia
2021-09-01
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| Series: | Malaysian Family Physician |
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| Online Access: | https://e-mfp.org/wp-content/uploads/v16n3-Oa-A-clinical-audit-of-the-diagnosis.pdf |
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| author | Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof |
| author_facet | Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof |
| author_sort | Jazlan Jamaluddin |
| collection | DOAJ |
| description | Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic.
Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies.
Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors.
Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic. |
| first_indexed | 2024-12-23T04:11:35Z |
| format | Article |
| id | doaj.art-919358e465b345a48812721b91dff748 |
| institution | Directory Open Access Journal |
| issn | 1985-2274 |
| language | English |
| last_indexed | 2024-12-23T04:11:35Z |
| publishDate | 2021-09-01 |
| publisher | Academy of Family Physicians of Malaysia |
| record_format | Article |
| series | Malaysian Family Physician |
| spelling | doaj.art-919358e465b345a48812721b91dff7482022-12-21T18:00:29ZengAcademy of Family Physicians of MalaysiaMalaysian Family Physician1985-22742021-09-01163687610.51866/oa1171A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinicJazlan Jamaluddin0Mohamed Syarif Mohamed Yassin1Siti Nuradliah Jamil2Mohd Azzahi Mohamed Kamel3Mohamad Ya’akob Yusof4Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, MalaysiaDepartment of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang Campus, Selangor, MalaysiaIntroduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.https://e-mfp.org/wp-content/uploads/v16n3-Oa-A-clinical-audit-of-the-diagnosis.pdfchronic renal insufficiencyclinical auditdiagnosisprimary health caremalaysia |
| spellingShingle | Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic Malaysian Family Physician chronic renal insufficiency clinical audit diagnosis primary health care malaysia |
| title | A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| title_full | A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| title_fullStr | A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| title_full_unstemmed | A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| title_short | A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| title_sort | clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic |
| topic | chronic renal insufficiency clinical audit diagnosis primary health care malaysia |
| url | https://e-mfp.org/wp-content/uploads/v16n3-Oa-A-clinical-audit-of-the-diagnosis.pdf |
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