Satoru Tatematsu1,2, Kazuo Kobayashi3,4, Yasunori Utsunomiya1, Taisuke Isozaki1, Tsuguru Hatta1, Takuo Kusumoto1, Masanobu Miyazaki1, Nobuo Hatori5, Haruhisa Otani1. 1. Committee of Kidney and Electrolyte Disease, Japan Physicians Association, Tokyo, Japan. 2. Division of Nephrology, Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 3. Committee of Kidney and Electrolyte Disease, Japan Physicians Association, Tokyo, Japan. k-taishi@xc4.so-net.ne.jp. 4. Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Kanagawa, Japan. k-taishi@xc4.so-net.ne.jp. 5. Kobayashi Hospital, Kanagawa, Japan.
Abstract
BACKGROUND: In 2019, a nationwide questionnaire survey on the management of chronic kidney disease (CKD) was circulated to general practitioners (GPs) throughout Japan by The Japan Physicians Association. The aim was to assess the current state of CKD medical care in the country and evaluate the utilization of CKD-specific guidelines in the treatment by GPs. METHODS: The voluntary survey targeted all members of Japan Physicians Association, a nationwide organization consisting primarily of 15,000 GPs in clinics throughout the country. GPs were divided into groups: 171 GPs using and 414 GPs not using the guidelines. Comparisons between the groups' responses were made using propensity score matching and component cluster analysis. RESULTS: Overall responses revealed that the estimated glomerular filtration rate's utilization rate was high (95.1%). However, evidence-practice gaps in urine protein quantification and anemia remedy were prominent. There were significantly favorable answers in terms of CKD management in the user group compared with those in the non-user group, except for the questions about a urine check at the first visit, stopping the use of renin-angiotensin system inhibitors, and the target blood pressure for elderly CKD patients. The differences suggest that utilization of the CKD guidelines has improved CKD management practices by GPs. CONCLUSIONS: Further promotion of CKD guidelines utilization (28% in this survey) is considered valid for CKD medical education.
BACKGROUND: In 2019, a nationwide questionnaire survey on the management of chronic kidney disease (CKD) was circulated to general practitioners (GPs) throughout Japan by The Japan Physicians Association. The aim was to assess the current state of CKD medical care in the country and evaluate the utilization of CKD-specific guidelines in the treatment by GPs. METHODS: The voluntary survey targeted all members of Japan Physicians Association, a nationwide organization consisting primarily of 15,000 GPs in clinics throughout the country. GPs were divided into groups: 171 GPs using and 414 GPs not using the guidelines. Comparisons between the groups' responses were made using propensity score matching and component cluster analysis. RESULTS: Overall responses revealed that the estimated glomerular filtration rate's utilization rate was high (95.1%). However, evidence-practice gaps in urine protein quantification and anemia remedy were prominent. There were significantly favorable answers in terms of CKD management in the user group compared with those in the non-user group, except for the questions about a urine check at the first visit, stopping the use of renin-angiotensin system inhibitors, and the target blood pressure for elderly CKD patients. The differences suggest that utilization of the CKD guidelines has improved CKD management practices by GPs. CONCLUSIONS: Further promotion of CKD guidelines utilization (28% in this survey) is considered valid for CKD medical education.
Authors: Francesco Pesce; Domenico Pasculli; Giuseppe Pasculli; Luca De Nicola; Mario Cozzolino; Antonio Granata; Loreto Gesualdo Journal: J Nephrol Date: 2022-06-14 Impact factor: 4.393