Abstract:The findings of this study can be used to inform the development and evaluation of interventions that target opportunistic CKD screening in the GP setting.
“…The major reason for the low referral uptake was GPs not initiating discussion on the risk assessment results. Also, the absence of an existing medical complaint might have enhanced participants’ reluctance to initiate discussion . Another contributing factor towards the low referral uptake could be the manner in which the results were communicated to the GP.…”
Section: Discussionmentioning
confidence: 99%
“…Also, the absence of an existing medical complaint might have enhanced participants' reluctance to initiate discussion. 22 Another contributing factor towards the low referral uptake could be the manner in which the results were communicated to the GP. All GPs were sent a referral letter; however, it is possible that not all of them had the opportunity to read it before the patient visit.…”
There is significant scope for improving early detection of CKD via implementation of a community pharmacy-based CKD risk assessment service. However, a healthcare system that encourages inter-professional collaboration between community pharmacists and GPs, and provides a robust referral pathway is needed to optimise the effectiveness of this service.
“…The major reason for the low referral uptake was GPs not initiating discussion on the risk assessment results. Also, the absence of an existing medical complaint might have enhanced participants’ reluctance to initiate discussion . Another contributing factor towards the low referral uptake could be the manner in which the results were communicated to the GP.…”
Section: Discussionmentioning
confidence: 99%
“…Also, the absence of an existing medical complaint might have enhanced participants' reluctance to initiate discussion. 22 Another contributing factor towards the low referral uptake could be the manner in which the results were communicated to the GP. All GPs were sent a referral letter; however, it is possible that not all of them had the opportunity to read it before the patient visit.…”
There is significant scope for improving early detection of CKD via implementation of a community pharmacy-based CKD risk assessment service. However, a healthcare system that encourages inter-professional collaboration between community pharmacists and GPs, and provides a robust referral pathway is needed to optimise the effectiveness of this service.
“… Box 4: Ensuring content directly addresses learning outcomes in CKD DETECT CKD DETECT was designed and developed to meet two key learning outcomes derived from the Kidney Health Australia ‐ Caring for Australians with Renal Insufficiency Guidelines (Johnson et al, ). A third outcome was developed from the findings of an elicitation study that identified the barriers and facilitators to opportunistic CKD screening by general practice nurses in an Australian primary care setting (Sinclair et al, ). This study concluded that many of the participants were familiar with risk criteria indicating who should be targeted for opportunistic screening and how screening should be undertaken.…”
Section: Identify Learning Outcomes and Ensure Content Will Delivermentioning
confidence: 99%
“…The majority of e-learning research to date has focused on user satisfaction, knowledge improvement, or self-efficacy relating to clinical skills using subjective selfreported measures (Lahti et al, 2014). Few studies have examined the effectiveness of e-learning programs on health care professional (HCP) behavior using objectively administered evaluation criteria (Sinclair et al, 2016a); however, those that have considered effectiveness used Objective Structured Clinical Examination (OSCE) (Cantarero-Villanueva et al, 2012) or Objective Structured Assessment of Technical Skills (OSAT) (Pape-Koehler et al, 2013). These processes are impractical for evaluating clinical skills and behavior change in the asynchronous e-learning environment.…”
Section: Incorporate Elements To Enhance Retention Transfer and Behmentioning
E-learning involves the transfer of skills and knowledge via technology so that learners can access meaningful and authentic educational materials. While learner engagement is important, in the context of healthcare education, pedagogy must not be sacrificed for edu-tainment style instructional design. Consequently, health professional educators need to be competent in the use of current web-based educational technologies so that learners are able to access relevant and engaging e-learning materials without restriction. The increasing popularity of asynchronous e-learning programs developed for use outside of formal education institutions has made this need more relevant. In these contexts, educators must balance design and functionality to deliver relevant, cost-effective, sustainable, and accessible programs that overcome scheduling and geographic barriers for learners. This paper presents 10 guiding design principles and their application in the development of an e-learning program for general practice nurses focused on behavior change. Consideration of these principles will assist educators to develop high quality, pedagogically sound, engaging, and interactive e-learning resources.
“…Therefore, exploration of how best to support primary care providers (PC-P) to detect and manage CKD is needed. While several studies have explored factors impacting the management of CKD in the primary care setting [7][8][9][10], there is a need to identify common barriers and enablers in order to develop effective strategies to enhance CKD care. While a systematic review of barriers to CKD management in primary care has been published [11], this study did not explore enabling factors.…”
Background: Chronic kidney disease (CKD) is growing population health concern worldwide, and with early identification and effective management, kidney disease progression can be slowed or prevented. Most patients with risk factors for chronic kidney disease are treated within primary healthcare. Therefore, it is important to understand how best to support primary care providers (PC-P) to detect and manage chronic kidney disease. The aim of this systematic review was to evaluate barriers and enablers to the diagnosis and management of CKD in primary care. Methods: A systematic review of qualitative research on the barriers and/or enablers to detection and/or management of CKD in adults within primary healthcare was conducted. The databases Medline (EBSCO), PubMed, Cochrane CENTRAL, CINAHL (EBSCO) and Joanna Briggs Institute Evidence Based Practice (Ovid) were searched until 27th August 2019. Barriers and/or enablers reported in each study were identified, classified into themes, and categorised according to the Theoretical Domains Framework. Results: A total of 20 studies were included in this review. The most commonly reported barriers related to detection and management of CKD in primary care were categorised into the 'Environmental context and resources' domain (n = 16 studies). Overall, the most common barrier identified was a lack of time (n = 13 studies), followed by a fear of delivering a diagnosis of CKD, and dissatisfaction with CKD guidelines (both n = 10 studies). Overall, the most common enabler identified was the presence of supportive technology to identify and manage CKD (n = 7 studies), followed by the presence of a collaborative relationship between members of the healthcare team (n = 5 studies). Conclusion: This systematic review identified a number of barriers and enablers which PC-P face when identifying and managing CKD. The findings of this review suggest a need for time-efficient strategies that promote collaboration between members of the healthcare team, and practice guidelines which consider the frequently comorbid nature of CKD. Enhanced collaboration between PC-P and nephrology services may also support PC-Ps when diagnosing CKD in primary care, and facilitate improved patient self-management.
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