Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data
<p><strong>Background: </strong>Much of chronic disease is managed in primary care and chronic kidney disease (CKD) is a recent addition. We are conducting a cluster randomised study of quality improvement interventions in CKD (QICKD) - Clinical Trials Registration: ISRCTN...
| Auteurs principaux: | , , , , , , , , , |
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| Format: | Journal article |
| Langue: | English |
| Publié: |
BioMed Central
2011
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| _version_ | 1826313893881839616 |
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| author | Tahir, MA Dmitrieva, O de Lusignan, S van Vlymen, J Chan, T Golmohamad, R Harris, K Tomson, C Thomas, N Gallagher, H |
| author_facet | Tahir, MA Dmitrieva, O de Lusignan, S van Vlymen, J Chan, T Golmohamad, R Harris, K Tomson, C Thomas, N Gallagher, H |
| author_sort | Tahir, MA |
| collection | OXFORD |
| description | <p><strong>Background: </strong>Much of chronic disease is managed in primary care and chronic kidney disease (CKD) is a recent addition. We are conducting a cluster randomised study of quality improvement interventions in CKD (QICKD) - Clinical Trials Registration: ISRCTN56023731. CKD registers have a lower than expected prevalence and an initial focus group study suggested variable levels of confidence in managing CKD.</p>
<p>Our objective is to compare practitioner confidence and achievement of quality indicators for CKD with hypertension and diabetes.</p>
<p><strong>Method: </strong>We validated a new questionnaire to test confidence. We compared confidence with achievement of pay-for-performance indicators (P4P) and implementation of evidence-based guidance. We achieved a 74% (148/201) response rate.</p>
<p><strong>Results: </strong>87% (n = 128) of respondents are confident in managing hypertension (HT) compared with 59% (n = 87) in managing HT in CKD (HT+CKD); and with 61% (n = 90) in HT, CKD and diabetes (CKD+HT+DM).</p>
<p>85.2% (P4P) and 62.5% (National targets) of patients with hypertension are at target; in patients with HT and CKD 65.1% and 53.3%; in patients with HT, CKD and DM 67.8% and 29.6%.</p>
<p>Confidence in managing proteinuria in CKD is low (42%, n = 62). 87% of respondents knew BP treatment thresholds in CKD, but only 53% when proteinuria is factored in. Male GPs, younger (< 35 yrs), and older (> 54 yrs) clinicians are more confident than females and 35 to 54 year olds in managing CKD.</p>
<p>84% of patients with hypertension treated with angiotensin modulating drugs achieve achieved P4P targets compared to 67% of patients with CKD.</p>
<p><strong>Conclusions: </strong>Practitioners are less likely to achieve management targets where their confidence is low.</p> |
| first_indexed | 2024-09-25T04:22:04Z |
| format | Journal article |
| id | oxford-uuid:67189092-94db-44e7-a7a7-67de17dd0144 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:22:04Z |
| publishDate | 2011 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:67189092-94db-44e7-a7a7-67de17dd01442024-08-16T14:22:50ZConfidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care dataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:67189092-94db-44e7-a7a7-67de17dd0144EnglishSymplectic ElementsBioMed Central2011Tahir, MADmitrieva, Ode Lusignan, Svan Vlymen, JChan, TGolmohamad, RHarris, KTomson, CThomas, NGallagher, H<p><strong>Background: </strong>Much of chronic disease is managed in primary care and chronic kidney disease (CKD) is a recent addition. We are conducting a cluster randomised study of quality improvement interventions in CKD (QICKD) - Clinical Trials Registration: ISRCTN56023731. CKD registers have a lower than expected prevalence and an initial focus group study suggested variable levels of confidence in managing CKD.</p> <p>Our objective is to compare practitioner confidence and achievement of quality indicators for CKD with hypertension and diabetes.</p> <p><strong>Method: </strong>We validated a new questionnaire to test confidence. We compared confidence with achievement of pay-for-performance indicators (P4P) and implementation of evidence-based guidance. We achieved a 74% (148/201) response rate.</p> <p><strong>Results: </strong>87% (n = 128) of respondents are confident in managing hypertension (HT) compared with 59% (n = 87) in managing HT in CKD (HT+CKD); and with 61% (n = 90) in HT, CKD and diabetes (CKD+HT+DM).</p> <p>85.2% (P4P) and 62.5% (National targets) of patients with hypertension are at target; in patients with HT and CKD 65.1% and 53.3%; in patients with HT, CKD and DM 67.8% and 29.6%.</p> <p>Confidence in managing proteinuria in CKD is low (42%, n = 62). 87% of respondents knew BP treatment thresholds in CKD, but only 53% when proteinuria is factored in. Male GPs, younger (< 35 yrs), and older (> 54 yrs) clinicians are more confident than females and 35 to 54 year olds in managing CKD.</p> <p>84% of patients with hypertension treated with angiotensin modulating drugs achieve achieved P4P targets compared to 67% of patients with CKD.</p> <p><strong>Conclusions: </strong>Practitioners are less likely to achieve management targets where their confidence is low.</p> |
| spellingShingle | Tahir, MA Dmitrieva, O de Lusignan, S van Vlymen, J Chan, T Golmohamad, R Harris, K Tomson, C Thomas, N Gallagher, H Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title | Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title_full | Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title_fullStr | Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title_full_unstemmed | Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title_short | Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data |
| title_sort | confidence and quality in managing ckd compared with other cardiovascular diseases and diabetes mellitus a linked study of questionnaire and routine primary care data |
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