Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review

Introduction There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implement...

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Main Authors: Celia C Kamath, M Hassan Murad, Claudia C Dobler, Patricia J Erwin, Bjorg Thorsteinsdottir, Michelle A Lampman, John Matulis, Muhamad Elrashidi, Rozalina Grubina McCoy, Mouaz Alsawaz, Atieh Pajouhi, Amrit Vasdev, Nilay D Shah
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e027206.full
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author Celia C Kamath
M Hassan Murad
Claudia C Dobler
Patricia J Erwin
Bjorg Thorsteinsdottir
Michelle A Lampman
John Matulis
Muhamad Elrashidi
Rozalina Grubina McCoy
Mouaz Alsawaz
Atieh Pajouhi
Amrit Vasdev
Nilay D Shah
author_facet Celia C Kamath
M Hassan Murad
Claudia C Dobler
Patricia J Erwin
Bjorg Thorsteinsdottir
Michelle A Lampman
John Matulis
Muhamad Elrashidi
Rozalina Grubina McCoy
Mouaz Alsawaz
Atieh Pajouhi
Amrit Vasdev
Nilay D Shah
author_sort Celia C Kamath
collection DOAJ
description Introduction There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions’ behavioural change components.Methods and analysis We will conduct a systematic review of studies from 2000 to October 2017 that evaluate implementation interventions targeting PCPs and which include at least one clinically meaningful CKD outcome. We will search several electronic data bases and conduct reference mining of related systematic reviews and publications. An interdisciplinary team will independently and in duplicate, screen publications, extract data and assess the risk of bias. Clinical outcomes will include all clinically meaningful medical management outcomes relevant to CKD management in primary care such as blood pressure, chronic heart disease and diabetes target achievements. Quantitative evidence synthesis will be performed, where possible. Planned subgroup analyses include by (1) study design, (2) length of follow-up, (3) type of intervention, (4) type of implementation strategy, (5) whether a behavioural or implementation theory was used to guide study, (6) baseline CKD severity, (7) patient minority status, (8) study location and (9) academic setting or not.Ethics and dissemination Approval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will inform a future trial of an intervention to promote uptake of CKD diagnosis and treatment guidelines in our primary care setting and the development of complementary tools to support its successful adoption and implementation. We will publish our findings in a peer-reviewed journal and develop accessible summaries of the results.PROSPERO registration number CRD42018102441.
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spelling doaj-art-66f085bd9422449b8c33abe4f58fdac82024-11-26T23:55:08ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2018-027206Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic reviewCelia C Kamath0M Hassan Murad1Claudia C Dobler2Patricia J Erwin3Bjorg Thorsteinsdottir4Michelle A Lampman5John Matulis6Muhamad Elrashidi7Rozalina Grubina McCoy8Mouaz Alsawaz9Atieh Pajouhi10Amrit Vasdev11Nilay D Shah12Health Care Policy and Research, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USAEvidence-Based Practice Center, Mayo Clinic, Rochester, Minnesota, USAEvidence-Based Practice Center, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USAMayo Medical Libraries, Mayo Clinic College of Medicine, Rochester, Minnesota, USADivision of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USAHealth Care Policy and Research, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USACommunity Internal Medicine, Mayo Clinic Minnesota, Rochester, Minnesota, USADivision of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USADivision of Endocrinology, Department of Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USAEvidence-Based Practice Center, Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USADivision of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USADivision of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota, USAHealth Sciences Research, Mayo Clinic, Rochester, Minnesota, USAIntroduction There is a considerable implementation gap in managing early stage chronic kidney disease (CKD) in primary care despite the high prevalence and risk for increased morbidity and mortality associated with CKD. This systematic review aims to synthesise the evidence of efficacy of implementation interventions aimed at primary care practitioners (PCPs) to improve CKD identification and management. We further aim to describe the interventions’ behavioural change components.Methods and analysis We will conduct a systematic review of studies from 2000 to October 2017 that evaluate implementation interventions targeting PCPs and which include at least one clinically meaningful CKD outcome. We will search several electronic data bases and conduct reference mining of related systematic reviews and publications. An interdisciplinary team will independently and in duplicate, screen publications, extract data and assess the risk of bias. Clinical outcomes will include all clinically meaningful medical management outcomes relevant to CKD management in primary care such as blood pressure, chronic heart disease and diabetes target achievements. Quantitative evidence synthesis will be performed, where possible. Planned subgroup analyses include by (1) study design, (2) length of follow-up, (3) type of intervention, (4) type of implementation strategy, (5) whether a behavioural or implementation theory was used to guide study, (6) baseline CKD severity, (7) patient minority status, (8) study location and (9) academic setting or not.Ethics and dissemination Approval by research ethics board is not required since the review will only include published and publicly accessible data. Review findings will inform a future trial of an intervention to promote uptake of CKD diagnosis and treatment guidelines in our primary care setting and the development of complementary tools to support its successful adoption and implementation. We will publish our findings in a peer-reviewed journal and develop accessible summaries of the results.PROSPERO registration number CRD42018102441.https://bmjopen.bmj.com/content/9/8/e027206.full
spellingShingle Celia C Kamath
M Hassan Murad
Claudia C Dobler
Patricia J Erwin
Bjorg Thorsteinsdottir
Michelle A Lampman
John Matulis
Muhamad Elrashidi
Rozalina Grubina McCoy
Mouaz Alsawaz
Atieh Pajouhi
Amrit Vasdev
Nilay D Shah
Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
BMJ Open
title Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
title_full Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
title_fullStr Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
title_full_unstemmed Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
title_short Implementation strategies for interventions to improve the management of chronic kidney disease (CKD) by primary care clinicians: protocol for a systematic review
title_sort implementation strategies for interventions to improve the management of chronic kidney disease ckd by primary care clinicians protocol for a systematic review
url https://bmjopen.bmj.com/content/9/8/e027206.full
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