Cynthia Delgado1, Kirsten L Johansen. 1. Nephrology Section, San Francisco VA Medical Center, University of California, San Francisco, CA 94121, USA. cynthia.delgado@ucsf.edu
Abstract
BACKGROUND: An evaluation of exercise counseling practices among nephrologists in 2001 demonstrated few clinicians assessing patients' levels of physical activity (PA) and counseling to increase activity. Recent Kidney Disease Outcomes Quality Initiative (KDOQI) cardiovascular guidelines recommended that nephrologists counsel patients to increase PA. Our objective was to ascertain whether nephrologists' counseling practices have changed. METHODS: We administered a 30-item survey regarding exercise counseling to nephrologists attending the ASN meeting in 2007. Some questions were adapted from a prior survey administered in 2001 to assess differences in practice patterns compared to 6 years earlier. RESULTS: Participants answered questions regarding opinions and practices relevant to PA (n = 198), KDOQI guidelines, self-reported PA, and demographic information (n = 173). Participants were 44 ± 11 years of age, 48% practicing in the USA, and 76% male. In multivariate analysis, older nephrologists (OR; 95% CI) (3.3; 1.2-9.0) and those more physically active (5.5; 2.0-14) were more likely to ask and counsel patients about PA. Opinions associated with less counseling behavior included lack of confidence in ability to discuss PA (0.2; 0.05-0.5). Multivariate comparison to previous respondents (n = 503) showed current nephrologists were not asking and counseling more (1.2; 0.81-1.8). CONCLUSION: Despite new guidelines, counseling behavior has not increased. Published guidelines are insufficient to reach younger nephrologists.
BACKGROUND: An evaluation of exercise counseling practices among nephrologists in 2001 demonstrated few clinicians assessing patients' levels of physical activity (PA) and counseling to increase activity. Recent Kidney Disease Outcomes Quality Initiative (KDOQI) cardiovascular guidelines recommended that nephrologists counsel patients to increase PA. Our objective was to ascertain whether nephrologists' counseling practices have changed. METHODS: We administered a 30-item survey regarding exercise counseling to nephrologists attending the ASN meeting in 2007. Some questions were adapted from a prior survey administered in 2001 to assess differences in practice patterns compared to 6 years earlier. RESULTS:Participants answered questions regarding opinions and practices relevant to PA (n = 198), KDOQI guidelines, self-reported PA, and demographic information (n = 173). Participants were 44 ± 11 years of age, 48% practicing in the USA, and 76% male. In multivariate analysis, older nephrologists (OR; 95% CI) (3.3; 1.2-9.0) and those more physically active (5.5; 2.0-14) were more likely to ask and counsel patients about PA. Opinions associated with less counseling behavior included lack of confidence in ability to discuss PA (0.2; 0.05-0.5). Multivariate comparison to previous respondents (n = 503) showed current nephrologists were not asking and counseling more (1.2; 0.81-1.8). CONCLUSION: Despite new guidelines, counseling behavior has not increased. Published guidelines are insufficient to reach younger nephrologists.
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