South Piedmont Area Health Education Center, Charlotte, NC, USA.
Department of Medicine, Division of Nephrology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
Postgrad Med. 2024 May;136(4):347-357. doi: 10.1080/00325481.2024.2350924. Epub 2024 May 11.
Clinical practice guidelines for the management of chronic kidney disease (CKD) associated with type 2 diabetes (T2D) are designed to assist healthcare professionals with clinical decision making by providing recommendations on the screening, detection, management, and treatment of these conditions. However, primary care practitioners (PCPs) may have clinical inertia when it comes to routinely enacting CKD and T2D guideline recommendations in their clinical practices. Guideline developers have published a range of resources with the aim of facilitating easier access to guideline recommendations to support efficient and consistent implementation into clinical practice of PCPs. Challenges remain in providing strategies to reduce inertia in the application of guideline recommendations in primary care. In this review, we explore reasons behind the low level of awareness and poor uptake of published evidence-based care approaches to the optimal management of patients with T2D and CKD. Finally, we present suggestions on strategies to improve the implementation of guideline-directed recommendations in primary care.
临床实践指南旨在为医疗保健专业人员提供有关筛查、检测、管理和治疗这些疾病的建议,以协助他们进行临床决策。然而,初级保健医生在其临床实践中可能存在对常规实施慢性肾脏病 (CKD) 和 2 型糖尿病 (T2D) 指南建议的临床惰性。指南制定者已经发布了一系列资源,旨在更方便地获取指南建议,以支持初级保健医生将其高效且一致地应用于临床实践。在为初级保健中减少惯性应用指南建议提供策略方面仍然存在挑战。在这篇综述中,我们探讨了对 T2D 和 CKD 患者进行最佳管理的基于发表证据的护理方法意识水平低和接受度差的背后原因。最后,我们提出了改善初级保健中指南指导建议实施的策略建议。