OBJECTIVE: To examine electronic records of GP management of chronic kidney disease. DESIGN: Cross-sectional study. SETTING: Thirteen general practices. PARTICIPANTS: Fifteen thousand four hundred and fiftteen active patients aged 50 years and over. MAIN OUTCOME MEASURE: Recorded estimated glomerular filtration rate (eGFR) and diabetes, and rate of prescribing of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACE/ARBs). RESULTS: Six thousand and fifty-nine (39%) patients had hypertension and 1859 (12%), diabetes. Two thousand six hundred and eighty-nine (17%) patients were recorded with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) , while 3344 (22%) did not have an eGFR result recorded. Hypertension, diabetes and eGFR <60 mL min(-1) (1.73 m(2) )(-1 ) were shown to be significantly related to prescribing of ACE/ARBs; however, 31% of known diabetics and 23% of diabetics with an eGFR < 60 mL min(-1) (1.73 m(2) )(-1 ) are not recorded as receiving ACE or ARB therapy. Forty-two per cent of patients with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) , are also not recorded as receiving ACE or ARB therapy. There was a 23% variation in the rates of prescribing of ACE/ARBs by practice for patients with diabetes and eGFR < 60 mL min(-1) (1.73 m(2) )(-1) . CONCLUSION: The overall recording of eGFR and the recorded prescribing of ACE or ARB therapy in known diabetics and patients with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) appear suboptimal. Also, the variations in prescribing between practices require further investigation.
OBJECTIVE: To examine electronic records of GP management of chronic kidney disease. DESIGN: Cross-sectional study. SETTING: Thirteen general practices. PARTICIPANTS: Fifteen thousand four hundred and fiftteen active patients aged 50 years and over. MAIN OUTCOME MEASURE: Recorded estimated glomerular filtration rate (eGFR) and diabetes, and rate of prescribing of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACE/ARBs). RESULTS: Six thousand and fifty-nine (39%) patients had hypertension and 1859 (12%), diabetes. Two thousand six hundred and eighty-nine (17%) patients were recorded with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) , while 3344 (22%) did not have an eGFR result recorded. Hypertension, diabetes and eGFR <60 mL min(-1) (1.73 m(2) )(-1 ) were shown to be significantly related to prescribing of ACE/ARBs; however, 31% of known diabetics and 23% of diabetics with an eGFR < 60 mL min(-1) (1.73 m(2) )(-1 ) are not recorded as receiving ACE or ARB therapy. Forty-two per cent of patients with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) , are also not recorded as receiving ACE or ARB therapy. There was a 23% variation in the rates of prescribing of ACE/ARBs by practice for patients with diabetes and eGFR < 60 mL min(-1) (1.73 m(2) )(-1) . CONCLUSION: The overall recording of eGFR and the recorded prescribing of ACE or ARB therapy in known diabetics and patients with eGFR < 60 mL min(-1) (1.73 m(2) )(-1) appear suboptimal. Also, the variations in prescribing between practices require further investigation.
Authors: Oyunbileg Magvanjav; Rhonda M Cooper-Dehoff; Caitrin W McDonough; Yan Gong; William R Hogan; Julie A Johnson Journal: Am J Hypertens Date: 2020-04-01 Impact factor: 2.689
Authors: Oyunbileg Magvanjav; Rhonda M Cooper-DeHoff; Caitrin W McDonough; Yan Gong; Mark S Segal; William R Hogan; Julie A Johnson Journal: J Clin Hypertens (Greenwich) Date: 2018-11-14 Impact factor: 3.738