Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus?
BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementa...
Ausführliche Beschreibung
Autor*in: |
Petra Martínez-Martínez [verfasserIn] Alfonso M. Cueto-Manzano [verfasserIn] Laura Cortés-Sanabria [verfasserIn] Héctor R. Martínez-Ramírez [verfasserIn] Enrique Rojas-Campos [verfasserIn] Aurora Hernández-Herrera [verfasserIn] |
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E-Artikel |
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Englisch |
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2022 |
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In: Frontiers in Medicine - Frontiers Media S.A., 2014, 9(2022) |
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Übergeordnetes Werk: |
volume:9 ; year:2022 |
Links: |
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DOI / URN: |
10.3389/fmed.2022.977937 |
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Katalog-ID: |
DOAJ08335655X |
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520 | |a BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. | ||
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10.3389/fmed.2022.977937 doi (DE-627)DOAJ08335655X (DE-599)DOAJ5a521164e1934559b4672bdb5d76d631 DE-627 ger DE-627 rakwb eng R5-920 Petra Martínez-Martínez verfasserin aut Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. educative intervention primary healthcare diabetes mellitus chronic kidney disease clinical practical guidelines Medicine (General) Petra Martínez-Martínez verfasserin aut Alfonso M. Cueto-Manzano verfasserin aut Laura Cortés-Sanabria verfasserin aut Héctor R. Martínez-Ramírez verfasserin aut Enrique Rojas-Campos verfasserin aut Aurora Hernández-Herrera verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.977937 kostenfrei https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 |
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10.3389/fmed.2022.977937 doi (DE-627)DOAJ08335655X (DE-599)DOAJ5a521164e1934559b4672bdb5d76d631 DE-627 ger DE-627 rakwb eng R5-920 Petra Martínez-Martínez verfasserin aut Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. educative intervention primary healthcare diabetes mellitus chronic kidney disease clinical practical guidelines Medicine (General) Petra Martínez-Martínez verfasserin aut Alfonso M. Cueto-Manzano verfasserin aut Laura Cortés-Sanabria verfasserin aut Héctor R. Martínez-Ramírez verfasserin aut Enrique Rojas-Campos verfasserin aut Aurora Hernández-Herrera verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.977937 kostenfrei https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 |
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10.3389/fmed.2022.977937 doi (DE-627)DOAJ08335655X (DE-599)DOAJ5a521164e1934559b4672bdb5d76d631 DE-627 ger DE-627 rakwb eng R5-920 Petra Martínez-Martínez verfasserin aut Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. educative intervention primary healthcare diabetes mellitus chronic kidney disease clinical practical guidelines Medicine (General) Petra Martínez-Martínez verfasserin aut Alfonso M. Cueto-Manzano verfasserin aut Laura Cortés-Sanabria verfasserin aut Héctor R. Martínez-Ramírez verfasserin aut Enrique Rojas-Campos verfasserin aut Aurora Hernández-Herrera verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.977937 kostenfrei https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 |
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10.3389/fmed.2022.977937 doi (DE-627)DOAJ08335655X (DE-599)DOAJ5a521164e1934559b4672bdb5d76d631 DE-627 ger DE-627 rakwb eng R5-920 Petra Martínez-Martínez verfasserin aut Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. educative intervention primary healthcare diabetes mellitus chronic kidney disease clinical practical guidelines Medicine (General) Petra Martínez-Martínez verfasserin aut Alfonso M. Cueto-Manzano verfasserin aut Laura Cortés-Sanabria verfasserin aut Héctor R. Martínez-Ramírez verfasserin aut Enrique Rojas-Campos verfasserin aut Aurora Hernández-Herrera verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.977937 kostenfrei https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 |
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10.3389/fmed.2022.977937 doi (DE-627)DOAJ08335655X (DE-599)DOAJ5a521164e1934559b4672bdb5d76d631 DE-627 ger DE-627 rakwb eng R5-920 Petra Martínez-Martínez verfasserin aut Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. educative intervention primary healthcare diabetes mellitus chronic kidney disease clinical practical guidelines Medicine (General) Petra Martínez-Martínez verfasserin aut Alfonso M. Cueto-Manzano verfasserin aut Laura Cortés-Sanabria verfasserin aut Héctor R. Martínez-Ramírez verfasserin aut Enrique Rojas-Campos verfasserin aut Aurora Hernández-Herrera verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.977937 kostenfrei https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022 |
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Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? |
abstract |
BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. |
abstractGer |
BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. |
abstract_unstemmed |
BackgroundThere are many clinical practice guidelines (CPGs) in Nephrology; however, there is no evidence that their availability has improved the clinical competence of physicians or the outcome of patients with chronic kidney disease (CKD). This study was aimed to evaluate the effect of implementation of CPGs for early CKD on family physicians (FP) clinical competence and subsequently on kidney function preservation of type 2 diabetes mellitus (DM2) patients at a primary healthcare setting.MethodsA prospective educative intervention (40-h) based on CPGs for Prevention, Diagnosis and Treatment of Early CKD was applied to FP; a questionnaire to evaluate clinical competence was applied at the beginning and end of the educative intervention (0 and 2 months), and 12 months afterwards. DM2 patients with CKD were evaluated during 1-year of follow-up with estimated glomerular filtration rate (eGFR) and albuminuria.ResultsAfter educative intervention, there was a significant increase in FP clinical competence compared to baseline; although it was reduced after 1 year, it remained higher compared to baseline. One-hundred thirteen patients with early nephropathy (58 stage 1, 55 stage 2) and 28 with overt nephropathy (23 stage 3, 5 stage 4) were studied. At final evaluation, both groups maintained eGFR [(mean change) early 0.20 ± 19 pNS; overt 0.51 ± 13 mL/min pNS], whereas albuminuria/creatinuria (early −67 ± 155 p < 0.0001; overt −301 ± 596 mg/g p < 0.0001), systolic blood pressure (early −10 ± 18 p < 0.05; overt −8 ± 20 mmHg p < 0.05), and total cholesterol (early −11 ± 31 p < 0.05; overt −17 ± 38 mg/dL p < 0.05) decreased. Diastolic blood pressure, waist circumference and LDL-cholesterol were also controlled in early nephropathy patients.ConclusionsCPGs for Prevention, Diagnosis and Treatment of CKD, by means of an educative intervention increases FP clinical competence and improves renal function in DM2 patients with CKD. |
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title_short |
Can the implementation of clinical practice guidelines improve clinical competence of physicians and kidney function of patients with type 2 diabetes mellitus? |
url |
https://doi.org/10.3389/fmed.2022.977937 https://doaj.org/article/5a521164e1934559b4672bdb5d76d631 https://www.frontiersin.org/articles/10.3389/fmed.2022.977937/full https://doaj.org/toc/2296-858X |
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Petra Martínez-Martínez Alfonso M. Cueto-Manzano Laura Cortés-Sanabria Héctor R. Martínez-Ramírez Enrique Rojas-Campos Aurora Hernández-Herrera |
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Petra Martínez-Martínez Alfonso M. Cueto-Manzano Laura Cortés-Sanabria Héctor R. Martínez-Ramírez Enrique Rojas-Campos Aurora Hernández-Herrera |
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up_date |
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