Primary care physicians' knowledge and practice patterns in the treatment of chronic kidney disease: An Upstate New York Practice-Based Research Network (UNYNET) study
Primary care physicians' knowledge and practice patterns in the treatment of chronic kidney disease: An Upstate New York Practice-Based Research Network (UNYNET) study
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DOI：
10.3122/jabfm.19.1.54
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发表时间：
2006-01-01
影响因子：
2.9
通讯作者：
Murray, Brian
中科院分区：
文献类型：
--
作者：
Fox, Chester H.;Brooks, Amanda;Murray, Brian
背景：在美国，慢性肾脏病（CKD）的患病率稳步上升。初级保健医生（PCP）可以参与被证明可以有效降低肾脏疾病进展率的策略。美国国家肾脏基金会发布了名为肾脏疾病结局质量改善倡议（K/DOQI）的循证指南，详细说明了这些策略。没有信息存在关于通过这些指南在初级care.Methods：一个定性研究的实践为基础的研究网络（PBRN）进行了探讨常见的PCP的做法和知识，关于CKD。采用典型病例抽样策略。半结构化访谈和退出调查进行了10个随机选择的PBRN做法的PCP。结果：主要发现有五个主题：（1）缺乏对K/DOQI指南的认识;（2）希望有更多的CKD实践指导;（3）传统的、不太准确的诊断程序的持续存在;（4）并发症治疗的可变性;（5）对慢性肾脏病的诊断和治疗方法。结论：面对日益增长的慢性肾脏病发病率，随着对新指南的熟悉，PCP可以对预防其进展和相关并发症产生影响。
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.