Open AccessReferral and management options for patients with chronic kidney disease: perspectives of patients, generalists and specialists
Author(s) -
Wilson Charlotte,
Campbell Stephen M.,
Luker Karen A.,
Caress AnnLouise
Publication year - 2015
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12025
Subject(s) - referral , medicine , kidney disease , family medicine , generalist and specialist species , telephone interview , public health , physical therapy , nursing , ecology , social science , sociology , habitat , biology
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 J uly and S eptember, 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.