Clinician’s use of automated reports of estimated glomerular filtration rate: A qualitative study

Details

• Personal Author:
  Smith, David H ; Schneider, Jennifer ; Thorp, Micah L ; Vupputuri, Suma ; Weiss, Jessica W ; Johnson, Eric S ; Feldstein, Adrianne ; Petrik, Amanda F ; Yang, Xuihai ; Snyder, Susan R
• Description:
  Background
  
  There is a growing awareness in primary care of the importance of identifying patients with chronic kidney disease (CKD) so that they can receive appropriate clinical care; one method that has been widely embraced is the use of automated reporting of estimated glomerular filtration rate (eGFR) by clinical laboratories. We undertook a qualitative study to examine how clinicians use eGFR in clinical decision making, patient communication issues, barriers to use of eGFR, and suggestions to improve the clinical usefulness of eGFR reports.
  
  Methods
  
  Our study used qualitative methods with structured interviews among primary care clinicians including both physicians and allied health providers, recruited from Kaiser Permanente Northwest, a non-profit health maintenance organization.
  
  Results
  
  We found that clinicians generally held favorable views toward eGFR reporting but did not use eGFR to replace serum creatinine in their clinical decision-making. Clinicians used eGFR as a tool to help identify CKD, educate patients about their kidney function and make treatment decisions. Barriers noted by several clinicians included a desire for greater education regarding care for patients with CKD and tools to facilitate discussion of eGFR findings with patients.
  
  Conclusions
  
  The manner in which clinicians use eGFRs appears to be more complex than previously understood, and our study illustrates some of the efforts that might be usefully undertaken (e.g. specific clinician education) when encouraging further promulgation of eGFR reporting and usage.
  
  
• Subjects:
  Decision Making Electronic Health Records Female Glomerular Filtration Rate Humans Male Physicians, Primary Care Primary Health Care Qualitative Research Renal Insufficiency, Chronic Research Report

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• Source:
  BMC Nephrol. 2012; 13:154.
• Document Type:
  Journal Article
• Volume:
  13
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a7a77e723cd3cfee785e4d91aef84ea48cada2ae1d53b2f5027cfe23d624096d76658fbed173dca756af93f27dbfbbc5a4e5283782fa765bd1cf3bb16642557c
• Download URL:
  https://stacks.cdc.gov/view/cdc/12146/cdc_12146_DS1.pdf
• File Type:
  [PDF - 242.37 KB ]