Provider perspectives on treatment decision-making in nephrotic syndrome
| Autor: | Marilyn Hailperin, Renee Pitter, Heather Beanlands, Maria Maione, Patrick H. Nachman, Howard Trachtman, Emily Herreshoff, Michelle A. Hladunewich, Mary Margaret Modes, Debbie S. Gipson, Jonathan P. Troost, Caroline J. Poulton |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Nephrotic Syndrome Attitude of Health Personnel media_common.quotation_subject Decision Making Disease Scarcity 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires medicine Outpatient clinic Humans 030212 general & internal medicine Disease management (health) Practice Patterns Physicians' Intensive care medicine Pace media_common Aged Transplantation business.industry 030503 health policy & services Disease Management Patient Preference Original Articles Middle Aged medicine.disease Exchange of information Nephrology Facilitator Practice Guidelines as Topic Female Perception 0305 other medical science business Kidney disease |
| Popis: | Background Managing patients with nephrotic syndrome (NS) remains difficult for the practicing nephrologist. This often young patient population is faced with a debilitating, relapsing and remitting disease with non-specific treatment options that are often poorly tolerated. Clinicians managing these complex patients must attempt to apply disease-specific evidence while considering the individual patient's clinical and personal situation. Methods We conducted qualitative interviews to ascertain the provider perspectives of NS, treatment options and factors that influence recommendations for disease management, and administered a survey to assess both facilitators and barriers to the implementation of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Results When making treatment recommendations, providers considered characteristics of various treatments such as efficacy, side effects and evaluation of risk versus benefit, taking into account how the specific treatment fit with the individual patient. Time constraints and the complexity of explaining the intricacies of NS were noted as significant barriers to care. Although the availability of guidelines was deemed a facilitator to care, the value of the KDIGO guidelines was limited by the perception of poor quality of evidence. Conclusions The complexity of NS and the scarcity of robust evidence to support treatment recommendations are common challenges reported by nephrologists. Future development and use of shared learning platforms may support the integration of best available evidence, patient/family preferences and exchange of information at a pace that is unconstrained by the outpatient clinic schedule. |
| Databáze: | OpenAIRE |
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