Developing a chronic kidney disease clinic in primary care
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Abstract
Chronic kidney disease (CKD) is a major problem of healthcare systems in Thailand. Diabetes and hypertension have become the most common causes of renal replacement therapy in CKD showing continuously increasing trends. The problem affects general public health, society and economics of the country. Therefore, a good screening system is needed to identify people at risk of CKD, and help prevent and delay progression of CKD before the end stage of kidney failure. Moreover, it could control the severity of complications especially potential heart and vascular diseases. Accordingly, this study aimed to develop a chronic kidney disease clinic in primary care. The objectives were to improve service quality and accessibility. The emphasis focused on developing personnel in primary health care and multidisciplinary disciplines. A one stop service network was created at the community level involving a network of partners operating in the community. The patient-centered care, was delivered using physician’s internal medicine under the supervision of a nephrologist involved to monitor the treatment process in the same direction. Information monitoring systems for patients with chronic kidney were developed to link effectively between the hospital and community care efforts. The results could achieve the goal of reducing or delaying CKD progression as well as complications in both risk and disease groups. Moreover, the CKD clinic in primary care was cost-effective and efficiently reduced mortality long term for patients with chronic kidney. disease.
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References
Ingsathit A, Thakkinstian A, Chaiprasert A, Sangthawan P, Gojaseni P, Kiattisunthorn K, et al. Prevalence and risk factors of chronic kidney disease in the Thai adult population: Thai SEEK study. Nephrol Dial Transplant.2010;25(5):1567–75.
Chuasuwan A., Lumpaopong A. Thailand Renal Replacement Therapy Register Report Year 2015. The Nephrology Society of Thailand [Internet]. [cited 2019, Nov18]. Available from: http://www.nephrothai.org/images/Final_TRT_report_2015.pdf
McBride D, Dohan D, Handley MA, Powe NR, Tuot DS. Developing a CKD registry in primary care: provider attitudes and input. Am J Kidney Dis. 2014; 63(4):577–83.
Kiousi E, Grapsa E. The role of an out-patient renal clinic in renal disease management. J Transl Int Med. 2015; 3(1):3–7.
Pongsittisak W. Chronic kidney disease multidisciplinay clinic. In: Urbanology for urban community 2016.p. 59–69.
The Nephrology Society of Thailand. Clinical Practice Recommendation for the Evaluation and Management of Chronic Kidney Disease in Adults 2015. p.1–25.
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2012;3:1-150.
Jiamjariyapon T, Ingsathit A, Pongpirul K, Vipattawat K, Kanchanakorn S, Saetie A, et al. Effectiveness of integrated care on delaying progression of stage 3-4 chronic kidney disease in rural communities of Thailand (ESCORT study): a cluster randomized controlled trial. BMC Nephrol. 2017;18(1):83.
Levin A, Lewis M, Mortiboy P, Faber S, Hare I, Porter EC, et al. Multidisciplinary predialysis programs: quantification and limitations of their impact on patient outcomes in two Canadian settings. Am J Kidney Dis. 1997; 29(4):533–40.
Peeters MJ, van Zuilen AD, van den Brand JAJG, Bots ML, van Buren M, Ten Dam MAGJ, et al. Nurse practitioner care improves renal outcome in patients with CKD. J Am Soc Nephrol. 2014; 25(2):390–8.
Hemmelgarn BR, Manns BJ, Zhang J, Tonelli M, Klarenbach S, Walsh M, et al. Association between multidisciplinary care and survival for elderly patients with chronic kidney disease. J Am Soc Nephrol. 2007;18(3):993–9.
Shi Y, Xiong J, Chen Y, Deng J, Peng H, Zhao J, et al. The effectiveness of multidisciplinary care models for patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol. 2018; 50(2):301–12.
Wei S-Y, Chang Y-Y, Mau L-W, Lin M-Y, Chiu H-C, Tsai J-C, et al. Chronic kidney disease care program improves quality of pre-end-stage renal disease care and reduces medical costs. Nephrology (Carlton). 2010; 15(1):108–15.
Lei C-C, Lee P-H, Hsu Y-C, Chang H-Y, Tung C-W, Shih Y-H, et al. Educational intervention in CKD retards disease progression and reduces medical costs for patients with stage 5 CKD. Ren Fail. 2013;35(1):9–16.
Sabariego C, Grill E, Brach M, Fritschka E, Mahlmeister J, Stucki G. Incremental cost-effectiveness analysis of a multidisciplinary renal education program for patients with chronic renal disease. Disabil Rehabil. 2010;32(5):392–401.
Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD, et al. Practical approach to detection and management of chronic kidney disease for the primary care clinician. Am J Med. 2016;129(2):153-162.e7.
Rosenberg M, Kalda R, Kasiulevicius V, Lember M. European Forum for Primary Care. Management of chronic kidney disease in primary health care: position paper of the European Forum for Primary Care. Qual Prim Care. 2008;16(4):279–94.
Mitra PK, Bradley JR. Chronic kidney disease in primary care. J R Soc Med. 2007; 100(1):40–5.
Johns TS, Yee J, Smith-Jules T, Campbell RC, Bauer C. Interdisciplinary care clinics in chronic kidney disease. BMC Nephrol. 2015; 16:161.
Narva AS, Norton JM, Boulware LE. Educating patients about CKD: The path to self-management and patient-centered care. Clin J Am Soc Nephrol. 2016; 11(4):694–703.
Havas K, Douglas C, Bonner A. Person-centred care in chronic kidney disease: a cross-sectional study of patients’ desires for self-management support. BMC Nephrol. 2017; 18(1):17.
Rojanamatin J. Annual report 2018. Department of medical services, Ministry of Public Health [Internet]. [cited 2020, Mar19] Available from: https://www.dms.moph.go.th/backend//Content/Content_File/Old_Content/dms2559/content/report_plan.pdf