Primary Care-Specialist Collaboration in the Care of Patients with Chronic Kidney Disease
Open Access
- 1 February 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 6 (2), 334-343
- https://doi.org/10.2215/cjn.06240710
Abstract
Background and objectives Collaboration between primary care physicians (PCPs) and nephrologists in the care of patients with chronic kidney disease (CKD) is widely advocated, but physician preferences regarding collaboration are unknown. Physicians' desires to collaborate in the care of a hypothetical patient with CKD, their preferred content of collaboration, and their perceived barriers to collaboration were assessed. Design, setting, participants, & measurements A questionnaire describing the care of a hypothetical patient with progressive CKD was administered to a national sample of U.S. PCPs and nephrologists. Physician characteristics and attitudes associated with desires to collaborate were identified. Results Among 124 PCPs and 120 nephrologists, most physicians (85% PCPs versus 94% nephrologists) desired collaboration. Nephrologists were more likely than PCPs to prefer collaboration focus on predialysis/renal replacement therapy preparation and electrolyte management (73% versus 52% and 81% versus 46%, respectively). PCPs were more likely to desire collaboration if the hypothetical patient had diabetes and hypertension (versus hypertension alone), if they believed the care they provide helps slow CKD disease progression, and if they did not perceive health insurance as a barrier to nephrology referral (adjusted percentages [95% confidence interval]: 94% [80 to 98] versus 75% [reference]), 92% [75 to 98] versus 75% [reference], 42% [9 to 85] versus 88% [reference], respectively). Conclusions Most PCPs and nephrologists favored collaborative care for a patient with progressive CKD, but their preferred content of collaboration differed. Collaborative models that explicitly include PCPs in the care of patients with CKD may help improve patients' clinical outcomes.This publication has 25 references indexed in Scilit:
- Chronic kidney disease care program improves quality of pre‐end‐stage renal disease care and reduces medical costsNephrology, 2010
- Optimal Preparation for ESRDClinical Journal of the American Society of Nephrology, 2009
- Analysis of Multidisciplinary Care Models and Interface With Primary Care in Management of Chronic Kidney DiseaseSeminars in Nephrology, 2009
- Clinical Testing Patterns and Cost Implications of Variation in the Evaluation of CKD Among US PhysiciansAmerican Journal of Kidney Diseases, 2009
- A systematic review of patient and health system characteristics associated with late referral in chronic kidney diseaseBMC Nephrology, 2008
- Association between Multidisciplinary Care and Survival for Elderly Patients with Chronic Kidney DiseaseJournal of the American Society of Nephrology, 2007
- Identification and Referral of Patients With Progressive CKD: A National StudyAmerican Journal of Kidney Diseases, 2006
- Referral of Patients to Specialists: Factors Affecting Choice of Specialist by Primary Care PhysiciansAnnals of Family Medicine, 2004
- The Role of Black and Hispanic Physicians in Providing Health Care for Underserved PopulationsThe New England Journal of Medicine, 1996
- How good is communication between primary care physicians and subspecialty consultants?Archives of Internal Medicine, 1984