A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
| Autor: | Siti Nuradliah Jamil, Mohamad Ya’akob Yusof, Jazlan Jamaluddin, Mohamed Syarif Mohamed Yassin, Mohd Azzahi Mohamed Kamel |
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| Rok vydání: | 2021 |
| Předmět: |
Community and Home Care
Clinical audit medicine.medical_specialty chronic renal insufficiency diagnosis business.industry clinical audit malaysia urologic and male genital diseases medicine.disease female genital diseases and pregnancy complications Primary care clinic primary health care Medicine Original Article Family Practice business Intensive care medicine Kidney disease |
| Zdroj: | Malays Fam Physician Malaysian Family Physician, Vol 16, Iss 3, Pp 68-76 (2021) |
| ISSN: | 1985-207X |
| Popis: | Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic. |
| Databáze: | OpenAIRE |
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