Exploration of chronic kidney disease screening, diagnosis and management in Australian general practice using electronic medical record data.

backgroundCKD is a common but under-recognised condition that places significant burden on the individual and the health system globally. Our study applied a set of primary care quality indicators originally developed and validated using Canadian primary care data for screening, diagnosis and monitoring of CKD. These indicators were then applied to a large primary care dataset to assess CKD detection and management practices in Australia.

methodsWe used de-identified data from the Patron repository, which contains data extracted from electronic medical records (EMRs) in Australian general practices. The 16 CKD indicators developed using Canadian EMR data were applied to this dataset. These indicators measured and reported on the use of clinical and pathological tests to diagnose and monitor CKD, the prescribing of antihypertensive and statin medications, and on rates of influenza immunisation.

resultsAmong the 362,078 unique patients identified across 78 general practices, 24,348 had a diagnosis or pathology consistent with CKD, of whom only 28.1% (6,841) had a diagnosis of CKD recorded. Of the 26,307 patients who initially presented with an eGFR below 60 ml/min/1.73m

conclusionsThe results of this study demonstrate that it is feasible to derive meaningful and informative indicators of CKD diagnosis and management from primary care EMR data in Australia, which are comparable with international data. The low rates of CKD documentation and pathology monitoring provide opportunities for quality improvement initiatives to reduce disease burden. CLINICAL TRIAL NUMBER: Not applicable.