Abstract: SA-PO1116
RevOCE CKD: Revolutionising Outpatient Care for Patients with CKD
Session Information
- CKD: Patient-Oriented Care and Case Reports
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- O'Keeffe, Hannah Marie, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Al-Chalabi, Saif, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Baricevic-Jones, Ivona, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Kapur, Pierina, Chapel Group Medical Centre, Manchester, Manchester, United Kingdom
- Gardner, Carlie Ann, Newbury Green Medical Centre, Manchester, Manchester, United Kingdom
- Mendell, Fiona, Newbury Green Medical Centre, Manchester, Manchester, United Kingdom
- Allen, Jude, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Santhirasekaran, Schanhave, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Robinson, Paul William, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Ritchie, James, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Kalra, Philip A., Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Poulikakos, Dimitrios J., Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
- Sinha, Smeeta, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
Background
Early detection of chronic kidney disease (CKD) including testing for urine albumin:creatinine ratio (uACR), and risk stratification using tools like the kidney failure risk equation (KFRE) enables proactive management. This facilitates the initiation of renoprotective therapies and earlier identification of patients at risk of progression who should be seen in specialist care.
This programme is a multifaceted Quality Improvement intervention to improve CKD management, including the establishment of a virtual multidisciplinary meeting (MDT) to provide specialist advice to General Practitioners (GPs), the creation of a pharmacy medications optimisation pathway, and the utilisation of data to highlight high risk patients.
Methods
Virtual MDTs were established as a pilot with two primary care practices, commencing March 2023. Five MDTs have been carried out in these practices, with an educational component, and approximately 6 patients discussed at each. The virtual MDTs have now been scaled to a third practice, and a primary care network where 8 practices meet together. The MDTs have been iterative, with changes made based on feedback. Patients have been selected by GPs for discussion and data from the practices has been used to identify high risk patients.
Results
Of patients (n=38) discussed at MDT, the majority were managed remotely (n=29, 76.3%) avoiding onward referral. More than 50% of patients discussed had medication changes (e.g. recommendation to commence an SGLT2 inhibitor).
The two practices involved in the project since commencement now have CKD coding significantly above average in the region; prevalence of 4.85% and 3.41%, compared to an average of 3.06%. They have uACR screening rates above average; 60.6% and 70.6%, compared to 45.2%. They have SGLT2 inhibitor prescribing rates above average at 35.9/1,000 and 45.8/1,000, versus 29.8/1,000 for the region.
Conclusion
This model has proven acceptable to primary care and can improve patient care, with quicker access to specialist input without the need for patients to be seen in clinic and the associated waiting times. We plan to scale this to additional practices and primary care networks with ongoing assessment of the outcomes and impact.