Referral and management options for patients with chronic kidney disease: Perspectives of patients, generalists and specialists

Charlotte Wilson, Stephen Campbell, Karen Luker, Caress Ann

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Chronic Kidney Disease (CKD) is increasing in prevalence and significance as a global public health issue. Appropriate management of CKD stages 3–4 in either generalist or specialist care is essential in order to slow disease progression. As various consulting options between services may be used, it is important to understand how patients and practitioners view these options. Objective To elicit patient and practitioner views and preferences on the acceptability and appropriateness of referral practices and consulting options for CKD stage 3–4. Design A mixed methods approach involving a semi-structured interview and structured rating exercise administered by telephone. Setting & participants Adult (18+) patients with CKD stage 3–4 were recruited via their General Practitioner (GP). Practitioners were recruited from both general and specialist services. Results Sixteen patients and twenty-two practitioners participated in the study between July and September, 2011. Both patients and practitioners preferred ‘GP with access to a specialist’ and least preferred ‘Specialist Review’. Computer review and telephone review were acceptable to participants under certain conditions. Practitioners favoured generalist management of patients with CKD 3. Specialists recommended active discharge of patients with stabilised stage 4 back to generalist care. Both generalists and specialists strongly supported sharing patients' medical records via electronic consultation systems. Conclusion Participants tended to prefer the current model of CKD management. Suggested improvements included; increasing the involvement of patients in referral and discharge decisions; improving the adequacy of information given to specialists on referral and encouraging further use of clinical guidelines in practice
Original languageEnglish
Pages (from-to)325-334
Number of pages10
JournalHealth Expectations
Volume18
Issue number3
DOIs
Publication statusPublished - 1 Jun 2015
Externally publishedYes

Fingerprint

Chronic Renal Insufficiency
Referral and Consultation
Telephone
General Practitioners
Patient Discharge
Electronic Health Records
Kidney Diseases
Practice Guidelines
Disease Progression
Public Health
Interviews
Exercise

Cite this

Wilson, Charlotte ; Campbell, Stephen ; Luker, Karen ; Ann, Caress. / Referral and management options for patients with chronic kidney disease: Perspectives of patients, generalists and specialists. In: Health Expectations. 2015 ; Vol. 18, No. 3. pp. 325-334.
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Referral and management options for patients with chronic kidney disease: Perspectives of patients, generalists and specialists. / Wilson, Charlotte; Campbell, Stephen; Luker, Karen; Ann, Caress.

In: Health Expectations, Vol. 18, No. 3, 01.06.2015, p. 325-334.

Research output: Contribution to journalArticle

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T1 - Referral and management options for patients with chronic kidney disease: Perspectives of patients, generalists and specialists

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AU - Campbell, Stephen

AU - Luker, Karen

AU - Ann, Caress

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N2 - Background Chronic Kidney Disease (CKD) is increasing in prevalence and significance as a global public health issue. Appropriate management of CKD stages 3–4 in either generalist or specialist care is essential in order to slow disease progression. As various consulting options between services may be used, it is important to understand how patients and practitioners view these options. Objective To elicit patient and practitioner views and preferences on the acceptability and appropriateness of referral practices and consulting options for CKD stage 3–4. Design A mixed methods approach involving a semi-structured interview and structured rating exercise administered by telephone. Setting & participants Adult (18+) patients with CKD stage 3–4 were recruited via their General Practitioner (GP). Practitioners were recruited from both general and specialist services. Results Sixteen patients and twenty-two practitioners participated in the study between July and September, 2011. Both patients and practitioners preferred ‘GP with access to a specialist’ and least preferred ‘Specialist Review’. Computer review and telephone review were acceptable to participants under certain conditions. Practitioners favoured generalist management of patients with CKD 3. Specialists recommended active discharge of patients with stabilised stage 4 back to generalist care. Both generalists and specialists strongly supported sharing patients' medical records via electronic consultation systems. Conclusion Participants tended to prefer the current model of CKD management. Suggested improvements included; increasing the involvement of patients in referral and discharge decisions; improving the adequacy of information given to specialists on referral and encouraging further use of clinical guidelines in practice

AB - Background Chronic Kidney Disease (CKD) is increasing in prevalence and significance as a global public health issue. Appropriate management of CKD stages 3–4 in either generalist or specialist care is essential in order to slow disease progression. As various consulting options between services may be used, it is important to understand how patients and practitioners view these options. Objective To elicit patient and practitioner views and preferences on the acceptability and appropriateness of referral practices and consulting options for CKD stage 3–4. Design A mixed methods approach involving a semi-structured interview and structured rating exercise administered by telephone. Setting & participants Adult (18+) patients with CKD stage 3–4 were recruited via their General Practitioner (GP). Practitioners were recruited from both general and specialist services. Results Sixteen patients and twenty-two practitioners participated in the study between July and September, 2011. Both patients and practitioners preferred ‘GP with access to a specialist’ and least preferred ‘Specialist Review’. Computer review and telephone review were acceptable to participants under certain conditions. Practitioners favoured generalist management of patients with CKD 3. Specialists recommended active discharge of patients with stabilised stage 4 back to generalist care. Both generalists and specialists strongly supported sharing patients' medical records via electronic consultation systems. Conclusion Participants tended to prefer the current model of CKD management. Suggested improvements included; increasing the involvement of patients in referral and discharge decisions; improving the adequacy of information given to specialists on referral and encouraging further use of clinical guidelines in practice

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KW - Humans

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KW - Male

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KW - Renal Insufficiency, Chronic/psychology

KW - General Practitioners/psychology

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KW - Interviews as Topic

KW - Aged

KW - Referral and Consultation

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