A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic

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...

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Autores principales:	Jazlan Jamaluddin, Mohamed Syarif Mohamed Yassin, Siti Nuradliah Jamil, Mohd Azzahi Mohamed Kamel, Mohamad Ya’akob Yusof
Formato:	article
Lenguaje:	EN
Publicado:	Academy of Family Physicians of Malaysia 2021
Materias:	chronic renal insufficiency clinical audit diagnosis primary health care malaysia Medicine R
Acceso en línea:	https://doaj.org/article/919358e465b345a48812721b91dff748
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spelling	oai:doaj.org-article:919358e465b345a48812721b91dff7482021-12-04T08:02:33ZA clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic10.51866/oa11711985-2274https://doaj.org/article/919358e465b345a48812721b91dff7482021-09-01T00:00:00Zhttps://e-mfp.org/wp-content/uploads/v16n3-Oa-A-clinical-audit-of-the-diagnosis.pdfhttps://doaj.org/toc/1985-2274Introduction: 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.Jazlan JamaluddinMohamed Syarif Mohamed YassinSiti Nuradliah JamilMohd Azzahi Mohamed KamelMohamad Ya’akob YusofAcademy of Family Physicians of Malaysiaarticlechronic renal insufficiencyclinical auditdiagnosisprimary health caremalaysiaMedicineRENMalaysian Family Physician, Vol 16, Iss 3, Pp 68-76 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic renal insufficiency clinical audit diagnosis primary health care malaysia Medicine R
spellingShingle	chronic renal insufficiency clinical audit diagnosis primary health care malaysia Medicine R Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
description	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.
format	article
author	Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof
author_facet	Jazlan Jamaluddin Mohamed Syarif Mohamed Yassin Siti Nuradliah Jamil Mohd Azzahi Mohamed Kamel Mohamad Ya’akob Yusof
author_sort	Jazlan Jamaluddin
title	A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
title_short	A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
title_full	A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
title_fullStr	A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
title_full_unstemmed	A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
title_sort	clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic
publisher	Academy of Family Physicians of Malaysia
publishDate	2021
url	https://doaj.org/article/919358e465b345a48812721b91dff748
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A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic

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