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Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review.
BMJ Open. 2019 08 08; 9(8):e027206.BO

Abstract

INTRODUCTION

There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions' behavioural change components.

METHODS AND ANALYSIS

We will conduct a systematic review of studies from 2000 to October 2017 that evaluate implementation interventions targeting PCPs and which include at least one clinically meaningful CKD outcome. We will search several electronic data bases and conduct reference mining of related systematic reviews and publications. An interdisciplinary team will independently and in duplicate, screen publications, extract data and assess the risk of bias. Clinical outcomes will include all clinically meaningful medical management outcomes relevant to CKD management in primary care such as blood pressure, chronic heart disease and diabetes target achievements. Quantitative evidence synthesis will be performed, where possible. Planned subgroup analyses include by (1) study design, (2) length of follow-up, (3) type of intervention, (4) type of implementation strategy, (5) whether a behavioural or implementation theory was used to guide study, (6) baseline CKD severity, (7) patient minority status, (8) study location and (9) academic setting or not.

ETHICS AND DISSEMINATION

Approval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will inform a future trial of an intervention to promote uptake of CKD diagnosis and treatment guidelines in our primary care setting and the development of complementary tools to support its successful adoption and implementation. We will publish our findings in a peer-reviewed journal and develop accessible summaries of the results.

PROSPERO REGISTRATION NUMBER

CRD42018102441.

Links

PMC Free PDF

Authors+Show Affiliations

Kamath CC
Health Care Policy and Research, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA kamath.celia@mayo.edu.
Dobler CC
Evidence-Based Practice Center, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Lampman MA
Health Care Policy and Research, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Erwin PJ
Mayo Medical Libraries, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Matulis J
Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Elrashidi M
Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
McCoy RG
Division of Endocrinology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Alsawaz M
Evidence-Based Practice Center, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Pajouhi A
Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Vasdev A
Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Shah ND
Health Care Policy and Research, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Murad MH
Evidence-Based Practice Center, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.
Thorsteinsdottir B
Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

MeSH

HumansPrimary Health CareQuality ImprovementRenal Insufficiency, ChronicResearch DesignSystematic Reviews as Topic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31399451

Citation

Kamath, Celia C., et al. "Implementation Strategies for Interventions to Improve the Management of Chronic Kidney Disease (CKD) By Primary Care Clinicians: Protocol for a Systematic Review." BMJ Open, vol. 9, no. 8, 2019, pp. e027206.
Kamath CC, Dobler CC, Lampman MA, et al. Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review. BMJ Open. 2019;9(8):e027206.
Kamath, C. C., Dobler, C. C., Lampman, M. A., Erwin, P. J., Matulis, J., Elrashidi, M., McCoy, R. G., Alsawaz, M., Pajouhi, A., Vasdev, A., Shah, N. D., Murad, M. H., & Thorsteinsdottir, B. (2019). Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review. BMJ Open, 9(8), e027206. https://doi.org/10.1136/bmjopen-2018-027206
Kamath CC, et al. Implementation Strategies for Interventions to Improve the Management of Chronic Kidney Disease (CKD) By Primary Care Clinicians: Protocol for a Systematic Review. BMJ Open. 2019 08 8;9(8):e027206. PubMed PMID: 31399451.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review. AU - Kamath,Celia C, AU - Dobler,Claudia C, AU - Lampman,Michelle A, AU - Erwin,Patricia J, AU - Matulis,John, AU - Elrashidi,Muhamad, AU - McCoy,Rozalina Grubina, AU - Alsawaz,Mouaz, AU - Pajouhi,Atieh, AU - Vasdev,Amrit, AU - Shah,Nilay D, AU - Murad,M Hassan, AU - Thorsteinsdottir,Bjorg, Y1 - 2019/08/08/ PY - 2019/8/11/entrez PY - 2019/8/11/pubmed PY - 2020/8/11/medline KW - chronic kidney disease KW - guideline implementation KW - implementation strategies KW - primary care practitioner interventions KW - systematic review protocol SP - e027206 EP - e027206 JF - BMJ open JO - BMJ Open VL - 9 IS - 8 N2 - INTRODUCTION: There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions' behavioural change components. METHODS AND ANALYSIS: We will conduct a systematic review of studies from 2000 to October 2017 that evaluate implementation interventions targeting PCPs and which include at least one clinically meaningful CKD outcome. We will search several electronic data bases and conduct reference mining of related systematic reviews and publications. An interdisciplinary team will independently and in duplicate, screen publications, extract data and assess the risk of bias. Clinical outcomes will include all clinically meaningful medical management outcomes relevant to CKD management in primary care such as blood pressure, chronic heart disease and diabetes target achievements. Quantitative evidence synthesis will be performed, where possible. Planned subgroup analyses include by (1) study design, (2) length of follow-up, (3) type of intervention, (4) type of implementation strategy, (5) whether a behavioural or implementation theory was used to guide study, (6) baseline CKD severity, (7) patient minority status, (8) study location and (9) academic setting or not. ETHICS AND DISSEMINATION: Approval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will inform a future trial of an intervention to promote uptake of CKD diagnosis and treatment guidelines in our primary care setting and the development of complementary tools to support its successful adoption and implementation. We will publish our findings in a peer-reviewed journal and develop accessible summaries of the results. PROSPERO REGISTRATION NUMBER: CRD42018102441. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/31399451/Implementation_strategies_for_interventions_to_improve_the_management_of_chronic_kidney_disease__CKD__by_primary_care_clinicians:_protocol_for_a_systematic_review_ DB - PRIME DP - Unbound Medicine ER -