Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study
BACKGROUND: The stages of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) reference ranges are currently determined without considering age. AIM: To determine whether a chart that graphs age with eGFR helps GPs make better decisions about managing patients with declining...
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2024
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Online Access: | https://research.bond.edu.au/en/publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 https://doi.org/10.3399/BJGPO.2023.0193 |
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ftbondunivcris:oai:https://pure.bond.edu.au/:publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 2024-06-16T07:40:01+00:00 Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study Guppy, Michelle Glasziou, Paul Jones, Mark Beller, Elaine Shaw, Jonathan E Barr, Elizabeth Doust, Jenny 2024-04-02 https://research.bond.edu.au/en/publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 https://doi.org/10.3399/BJGPO.2023.0193 eng eng https://research.bond.edu.au/en/publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 info:eu-repo/semantics/openAccess Guppy , M , Glasziou , P , Jones , M , Beller , E , Shaw , J E , Barr , E & Doust , J 2024 , ' Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study ' , BJGP Open , pp. 1-9 . https://doi.org/10.3399/BJGPO.2023.0193 article 2024 ftbondunivcris https://doi.org/10.3399/BJGPO.2023.0193 2024-05-23T00:06:54Z BACKGROUND: The stages of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) reference ranges are currently determined without considering age. AIM: To determine whether a chart that graphs age with eGFR helps GPs make better decisions about managing patients with declining eGFR. DESIGN & SETTING: A randomised controlled vignette study among Australian GPs using a percentile chart plotting the trajectory of eGFR by age. METHOD: Three hundred and seventy-three GPs received two case studies of patients with declining renal function. They were randomised to receive the cases with the chart or without the chart, and asked a series of questions about how they would manage the cases. RESULTS: In an older female patient with stable but reduced kidney function, use of the chart was associated with GPs in the study recommending a longer follow-up period, and longer time until repeat pathology testing. In a younger male First Nations patient with normal but decreasing kidney function, use of the chart was associated with GPs in the study recommending a shorter follow-up period, shorter time to repeat pathology testing, increased management of blood pressure and lifestyle, and avoidance of nephrotoxic medications. This represents more appropriate care in both cases. CONCLUSION: Having access to a chart of percentile eGFR by age was associated with more appropriate management review periods of patients with reduced kidney function, either by greater compliance with current guidelines or greater awareness of a clinically relevant kidney problem. Article in Journal/Newspaper First Nations Bond University Research Portal BJGP Open BJGPO.2023.0193 |
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Bond University Research Portal |
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ftbondunivcris |
language |
English |
description |
BACKGROUND: The stages of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) reference ranges are currently determined without considering age. AIM: To determine whether a chart that graphs age with eGFR helps GPs make better decisions about managing patients with declining eGFR. DESIGN & SETTING: A randomised controlled vignette study among Australian GPs using a percentile chart plotting the trajectory of eGFR by age. METHOD: Three hundred and seventy-three GPs received two case studies of patients with declining renal function. They were randomised to receive the cases with the chart or without the chart, and asked a series of questions about how they would manage the cases. RESULTS: In an older female patient with stable but reduced kidney function, use of the chart was associated with GPs in the study recommending a longer follow-up period, and longer time until repeat pathology testing. In a younger male First Nations patient with normal but decreasing kidney function, use of the chart was associated with GPs in the study recommending a shorter follow-up period, shorter time to repeat pathology testing, increased management of blood pressure and lifestyle, and avoidance of nephrotoxic medications. This represents more appropriate care in both cases. CONCLUSION: Having access to a chart of percentile eGFR by age was associated with more appropriate management review periods of patients with reduced kidney function, either by greater compliance with current guidelines or greater awareness of a clinically relevant kidney problem. |
format |
Article in Journal/Newspaper |
author |
Guppy, Michelle Glasziou, Paul Jones, Mark Beller, Elaine Shaw, Jonathan E Barr, Elizabeth Doust, Jenny |
spellingShingle |
Guppy, Michelle Glasziou, Paul Jones, Mark Beller, Elaine Shaw, Jonathan E Barr, Elizabeth Doust, Jenny Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
author_facet |
Guppy, Michelle Glasziou, Paul Jones, Mark Beller, Elaine Shaw, Jonathan E Barr, Elizabeth Doust, Jenny |
author_sort |
Guppy, Michelle |
title |
Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
title_short |
Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
title_full |
Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
title_fullStr |
Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
title_full_unstemmed |
Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
title_sort |
kidney trajectory charts improve gp management of patients with reduced kidney function: a randomised controlled vignette study |
publishDate |
2024 |
url |
https://research.bond.edu.au/en/publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 https://doi.org/10.3399/BJGPO.2023.0193 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
Guppy , M , Glasziou , P , Jones , M , Beller , E , Shaw , J E , Barr , E & Doust , J 2024 , ' Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study ' , BJGP Open , pp. 1-9 . https://doi.org/10.3399/BJGPO.2023.0193 |
op_relation |
https://research.bond.edu.au/en/publications/246135c2-4cbd-4ae5-840b-478bc7ae0133 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.3399/BJGPO.2023.0193 |
container_title |
BJGP Open |
container_start_page |
BJGPO.2023.0193 |
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1802006840842649600 |