Primary Care Faces Challenges in Caring for Kidney Disease

Primary care providers (PCPs) report substantial, but modifiable, barriers to caring for patients with chronic kidney disease (CKD), according to a study published online in PLOS ONE.

C. John Sperati, M.D., from Johns Hopkins University School of Medicine in Baltimore, and colleagues surveyed and conducted focus groups of 32 community-based PCPs in four U.S. cities (Baltimore; St. Louis; Raleigh, North Carolina; and San Francisco) to identify key barriers and facilitators to the management of patients with CKD in primary care.

The researchers reported that PCPs identified multiple barriers to managing CKD in primary care, including at the patient level (e.g., low awareness of CKD, poor adherence to treatment recommendations), provider level (e.g., staying current with CKD guidelines), and the health care system level (e.g., inflexible electronic medical records and limited time and resources). Fourteen of 31 respondents said that they did not follow professional society guidelines. Further, only two of 32 said they had educational tools and resources available to help patients understand and self-manage their day-to-day CKD needs. Ideas to improve CKD care included electronic prompts and lab decision support, concise guidelines, and health care financing reform.

"The National Kidney Foundation and others in the nephrology community have worked hard to engage primary care physicians in the management of CKD patients, and this study should help to further refine and strengthen those efforts," Sperati said in a statement.

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