Evidence map›Paper›PMID 26355134›Full record

Trial reportJournal of the American Board of Family Medicine : JABFM

Chronic Kidney Disease Guideline Implementation in Primary Care: A Qualitative Report from the TRANSLATE CKD Study.

Bonnie M Vest, Trevor R M York, Jessica Sand, Chester H Fox, Linda S Kahn

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Bonnie M VestFrom the Department of Family Medicine, State University of New York at Buffalo (BMV, CHF, LSK); the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY (TRMY); and the American Academy of Family Physicians National Research Network, Leawood, KS (JS). bvest@buffalo.edu.
Trevor R M YorkFrom the Department of Family Medicine, State University of New York at Buffalo (BMV, CHF, LSK); the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY (TRMY); and the American Academy of Family Physicians National Research Network, Leawood, KS (JS).
Jessica SandFrom the Department of Family Medicine, State University of New York at Buffalo (BMV, CHF, LSK); the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY (TRMY); and the American Academy of Family Physicians National Research Network, Leawood, KS (JS).
Chester H FoxFrom the Department of Family Medicine, State University of New York at Buffalo (BMV, CHF, LSK); the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY (TRMY); and the American Academy of Family Physicians National Research Network, Leawood, KS (JS).
Linda S KahnFrom the Department of Family Medicine, State University of New York at Buffalo (BMV, CHF, LSK); the State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY (TRMY); and the American Academy of Family Physicians National Research Network, Leawood, KS (JS).

Funding

Improving Evidence-Based Primary Care for Chronic Kidney DiseaseR01DK090407 · NIDDK · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI FOX, CHESTER H · 2011 to 2015
$3.3M
NIDDK NIH HHS R01 DK090407
6 · The paper itself

Abstract

backgroundPrimary care physicians (PCPs) are optimally situated to identify and manage early stage chronic kidney disease (CKD). Nonetheless, studies have documented suboptimal PCP understanding, awareness, and management of early CKD. The TRANSLATE CKD study is an ongoing national, mixed-methods, cluster randomized control trial that examines the implementation of evidence-based guidelines for CKD into primary care practice.

methodsAs part of the mixed-methods process evaluation, semistructured interviews were conducted by phone with 27 providers participating in the study. Interviews were audio-taped and transcribed. Thematic content analysis was used to identify themes. Themes were categorized according to the 4 domains of Normalization Process Theory (NPT).

resultsIdentified themes illuminated the complex work undertaken to manage CKD in primary care practices. Barriers to guideline implementation were identified in each of the 4 NPT domains, including (1) lack of knowledge and understanding around CKD (coherence), (2) difficulties engaging providers and patients in CKD management (cognitive participation), (3) limited time and competing demands (collective action), and (4) challenges obtaining and using data to monitor progress (reflexive monitoring).

conclusionsAddressing the barriers to implementation with concrete interventions at the levels at which they occur, informed by NPT, will ultimately improve the quality of CKD patient care.

Indexed as

Attitude of Health PersonnelDisease ManagementQualitative ResearchFemaleHumansMalePhysicians, Primary CarePrimary Health CareRenal Insufficiency, ChronicRetrospective StudiesUnited StatesChronic Renal DiseasesNormalization Process TheoryPrimary Health CareQualitative Research

Identifiers

PMID26355134
PMCPMC4815897

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.