SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Quality-improvement strategies for the management of hypertension in chronic kidney disease in primary care: a systematic review.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of clinical pharmacy services: an overview of systematic reviews (2000-2010).International journal of clinical pharmacy · 2015Pooled it
- Development of a questionnaire to evaluate practitioners' confidence and knowledge in primary care in managing chronic kidney disease.BMC nephrology · 2014Trial
- Audit-based education lowers systolic blood pressure in chronic kidney disease: the Quality Improvement in CKD (QICKD) trial results.Kidney international · 2013Trial
- Confidence and quality in managing CKD compared with other cardiovascular diseases and diabetes mellitus: a linked study of questionnaire and routine primary care data.BMC family practice · 2011Trial
- Uncoded chronic kidney disease in primary care: a cross-sectional study of inequalities and cardiovascular disease risk management.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Improving coding and primary care management for patients with chronic kidney disease: an observational controlled study in East London.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Observational
- Behavior change interventions and policies influencing primary healthcare professionals' practice-an overview of reviews.Implementation science : IS · 2017Review
- Chronic kidney disease: identification and management in primary care.Pragmatic and observational research · 2016Review
- Electronic Health Record Patient Portals in CKD and Hypertension Management: Meaningfully Used?Clinical journal of the American Society of Nephrology : CJASN · 2015Article
- Serum renalase is related to catecholamine levels and renal function.Clinical and experimental nephrology · 2015Article
- Implementation of a CKD checklist for primary care providers.Clinical journal of the American Society of Nephrology : CJASN · 2014Article
- A quality improvement project to improve the effectiveness and patient-centredness of management of people with mild-to-moderate kidney disease in primary care.BMJ quality improvement reports · 2014Article
- Hypertension management initiative prospective cohort study: comparison between immediate and delayed intervention groups.Journal of human hypertension · 2014Article
- Informatics as tool for quality improvement: rapid implementation of guidance for the management of chronic kidney disease in England as an exemplar.Healthcare informatics research · 2013Article
- Treatment for substance use disorder: opportunities and challenges under the affordable care act.Social work in public health · 2013Article
- The role of primary care in managing chronic kidney disease.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- How ready is general practice to improve quality in chronic kidney disease? A diagnostic analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic kidney disease (CKD) is a relatively recently recognised condition. People with CKD are much more likely to suffer from cardiovascular events than progress to established renal failure. Controlling systolic blood pressure should slow the progression of disease and reduce mortality and morbidity. However, no systematic review has been conducted to explore the effectiveness of quality-improvement interventions to lower blood pressure in people with CKD.
aimTo assess the effectiveness of quality-improvement interventions to reduce systolic blood pressure in people with CKD in primary care, in order to reduce cardiovascular risk and slow the progression of renal disease.
methodPapers were identified from the trial data bases of the Cochrane Effective Practice and Organisation of Care Group (EPOC) and Cochrane renal groups. In a three-round process, at least two investigators read the papers independently. Studies were initially excluded based on their abstracts, if these were not relevant to primary care. Next, full papers were read, and again excluded on relevance. Quantitative and, where this was not possible, qualitative analyses of the findings were performed.
resultsThe selected studies were usually carried out on high-risk populations including ethnic minorities. The interventions were most often led by nurses or pharmacists. Three randomised trials showed a combined effect of a reduction in systolic blood pressure of 10.50 mmHg (95% confidence interval [CI] = 5.34 to 18.41 mmHg). One non-randomised study showed a reduction in systolic blood pressure of 9.30 mmHg (95% CI = 3.01 to 15.58 mmHg).
conclusionQuality-improvement interventions can be effective in lowing blood pressure, and potentially in reducing cardiovascular risk and slowing progression in CKD. Trials are needed in low-risk populations to see if the same improvements can be achieved.
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Registered trials
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