Making treatment guideline recommendations in chronic kidney disease and type 2 diabetes more accessible to primary care providers in the United States.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 0401147 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1941-9260 (Electronic) Linking ISSN: 00325481 NLM ISO Abbreviation: Postgrad Med Subsets: MEDLINE

Publication: 2015- : London : Informa Healthcare
Original Publication: New York : Vendome Group, -2006

Diabetes Mellitus, Type 2*/therapy ; Renal Insufficiency, Chronic*/therapy ; Primary Health Care*/standards ; Practice Guidelines as Topic*; Humans ; United States ; Guideline Adherence ; Physicians, Primary Care

Clinical practice guidelines for the management of chronic kidney disease (CKD) associated with type 2 diabetes (T2D) are designed to assist healthcare professionals with clinical decision making by providing recommendations on the screening, detection, management, and treatment of these conditions. However, primary care practitioners (PCPs) may have clinical inertia when it comes to routinely enacting CKD and T2D guideline recommendations in their clinical practices. Guideline developers have published a range of resources with the aim of facilitating easier access to guideline recommendations to support efficient and consistent implementation into clinical practice of PCPs. Challenges remain in providing strategies to reduce inertia in the application of guideline recommendations in primary care. In this review, we explore reasons behind the low level of awareness and poor uptake of published evidence-based care approaches to the optimal management of patients with T2D and CKD. Finally, we present suggestions on strategies to improve the implementation of guideline-directed recommendations in primary care.

Keywords: Chronic kidney disease; clinical decision making; clinical practice guidelines; guideline implementation; primary care; type 2 diabetes
Local Abstract: [plain-language-summary] Clinical practice guidelines for managing chronic kidney disease (CKD) for people who also have type 2 diabetes (T2D) provide healthcare providers with recommendations on how to identify, diagnose, and treat CKD. Although treatments cannot cure CKD, they can help to reduce the risk of CKD getting worse. The recommendations are based on results of clinical trials that tested how safe and how well a medication works among many people with CKD and T2D. If these clinical trials show that the medicine is beneficial for people with CKD and T2D, then it may be included in guideline recommendations. Most people living with T2D and early-stage CKD are treated by their primary care practitioner (PCP). If PCPs are not fully aware of guideline recommendations, then their patients may lose the opportunity to receive medications that can benefit them. PCPs have said that barriers to implementing guideline recommendations in their clinical practices include too many guidelines and that the guidelines are difficult to understand and use in their offices. Guideline developers have thought of ways to make the guidelines easier to access and use. This includes putting the guidelines onto mobile apps, providing online resources, making versions more relevant to PCPs, and combining multiple guidelines. These approaches are helpful, but more work is needed. This review article talks about the reasons why PCPs are not always aware of the most up-to-date guideline recommendations for CKD and T2D, how guideline developers have found different ways of sharing the guideline recommendations, and what more can be done.

Date Created: 20240507 Date Completed: 20240620 Latest Revision: 20240625

20240625

10.1080/00325481.2024.2350924

38712604