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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Royal College of General Practitioners
2024
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Online Access: | https://doi.org/10.3399/BJGPO.2023.0193 https://doaj.org/article/6781ed7c1f2142b19c26cafa4c81b698 |
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ftdoajarticles:oai:doaj.org/article:6781ed7c1f2142b19c26cafa4c81b698 2024-09-15T18:06:47+00:00 Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study Michelle Guppy Paul Glasziou Mark Jones Elaine Beller Jonathan E Shaw Elizabeth Barr Jenny Doust 2024-07-01T00:00:00Z https://doi.org/10.3399/BJGPO.2023.0193 https://doaj.org/article/6781ed7c1f2142b19c26cafa4c81b698 EN eng Royal College of General Practitioners https://online.boneandjoint.org.uk/doi/epdf/10.3399/BJGPO.2023.0193 https://doaj.org/toc/2398-3795 2398-3795 doi:10.3399/BJGPO.2023.0193 https://doaj.org/article/6781ed7c1f2142b19c26cafa4c81b698 BJGP Open, Vol 8, Iss 2 (2024) aging australia general practice glomerular filtration rate kidney overdiagnosis primary health care renal insufficiency chronic Medicine (General) R5-920 article 2024 ftdoajarticles https://doi.org/10.3399/BJGPO.2023.0193 2024-08-12T15:24:05Z 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 Directory of Open Access Journals: DOAJ Articles BJGP Open 8 2 BJGPO.2023.0193 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
aging australia general practice glomerular filtration rate kidney overdiagnosis primary health care renal insufficiency chronic Medicine (General) R5-920 |
spellingShingle |
aging australia general practice glomerular filtration rate kidney overdiagnosis primary health care renal insufficiency chronic Medicine (General) R5-920 Michelle Guppy Paul Glasziou Mark Jones Elaine Beller Jonathan E Shaw Elizabeth Barr Jenny Doust Kidney trajectory charts improve GP management of patients with reduced kidney function: a randomised controlled vignette study |
topic_facet |
aging australia general practice glomerular filtration rate kidney overdiagnosis primary health care renal insufficiency chronic Medicine (General) R5-920 |
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 |
Michelle Guppy Paul Glasziou Mark Jones Elaine Beller Jonathan E Shaw Elizabeth Barr Jenny Doust |
author_facet |
Michelle Guppy Paul Glasziou Mark Jones Elaine Beller Jonathan E Shaw Elizabeth Barr Jenny Doust |
author_sort |
Michelle Guppy |
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 |
publisher |
Royal College of General Practitioners |
publishDate |
2024 |
url |
https://doi.org/10.3399/BJGPO.2023.0193 https://doaj.org/article/6781ed7c1f2142b19c26cafa4c81b698 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
BJGP Open, Vol 8, Iss 2 (2024) |
op_relation |
https://online.boneandjoint.org.uk/doi/epdf/10.3399/BJGPO.2023.0193 https://doaj.org/toc/2398-3795 2398-3795 doi:10.3399/BJGPO.2023.0193 https://doaj.org/article/6781ed7c1f2142b19c26cafa4c81b698 |
op_doi |
https://doi.org/10.3399/BJGPO.2023.0193 |
container_title |
BJGP Open |
container_volume |
8 |
container_issue |
2 |
container_start_page |
BJGPO.2023.0193 |
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1810444157232087040 |