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Renal medicine
Protocol
A national surveillance project on chronic kidney disease management in Canadian primary care: a study protocol
  1. Aminu K Bello1,
  2. Paul E Ronksley2,
  3. Navdeep Tangri3,
  4. Alexander Singer4,
  5. Allan Grill5,
  6. Dorothea Nitsch6,
  7. John A Queenan7,
  8. Cliff Lindeman8,
  9. Boglarka Soos9,
  10. Elizabeth Freiheit10,
  11. Delphine Tuot11,
  12. Dee Mangin12,
  13. Neil Drummond13
  1. 1 Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  2. 2 Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
  3. 3 Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
  4. 4 Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
  5. 5 Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
  6. 6 Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
  7. 7 Department of Family Medicine, Epidemiologist for the Canadian Primary Care Sentinel Surveillance Network, Queen's University in Kingston, Ontario, Canada
  8. 8 Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
  9. 9 Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
  10. 10 Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
  11. 11 Department of Medicine, UCSF School of Medicine, San Francisco, California, USA
  12. 12 Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
  13. 13 Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Aminu K Bello; aminu1{at}ualberta.ca

Abstract

Introduction Effective chronic disease care is dependent on well-organised quality improvement (QI) strategies that monitor processes of care and outcomes for optimal care delivery. Although healthcare is provincially/territorially structured in Canada, there are national networks such as the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) as important facilitators for national QI-based studies to improve chronic disease care. The goal of our study is to improve the understanding of how patients with chronic kidney disease (CKD) are managed in primary care and the variation across practices and provinces and territories to drive improvements in care delivery.

Methods and analysis The CPCSSN database contains anonymised health information from the electronic medical records for patients of participating primary care practices (PCPs) across Canada (n=1200). The dataset includes information on patient sociodemographics, medications, laboratory results and comorbidities. Leveraging validated algorithms, case definitions and guidelines will help define CKD and the related processes of care, and these enable us to: (1) determine prevalent CKD burden; (2) ascertain the current practice pattern on risk identification and management of CKD and (3) study variation in care indicators (eg, achievement of blood pressure and proteinuria targets) and referral pattern for specialist kidney care. The process of care outcomes will be stratified across patients’ demographics as well as provider and regional (provincial/territorial) characteristics. The prevalence of CKD stages 3–5 will be presented as age–sex standardised prevalence estimates stratified by province and as weighted averages for population rates with 95% CIs using census data. For each PCP, age–sex standardised prevalence will be calculated and compared with expected standardised prevalence estimates. The process-based outcomes will be defined using established methods.

Ethics and dissemination The CPCSSN is committed to high ethical standards when dealing with individual data collected, and this work is reviewed and approved by the Network Scientific Committee. The results will be published in peer-reviewed journals and presented at relevant national and international scientific meetings.

  • quality in health care
  • nephrology
  • chronic renal failure

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-016267

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    Footnotes

    • Contributors AKB and ND had the original idea for this study. AKB and PER wrote the first draft of the manuscript. PER, NT, AS, AG, DN, JAQ, CL, LBS, EF, DT and DM contributed to the development of the idea and the study design and reviewed the manuscript for intellectual content. All authors approved the final submitted version of the manuscript.

    • Funding This work is supported by the Canadian Institute of Health Research (CIHR) Operating Grant: SPOR PIHCI Network: Quick Strikes Grant (reference no RN281786) through the Universities of Alberta and Manitoba, and McMaster University.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the CIHR,CPCSSN or the various institutions represented.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval University of Alberta Health Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The authors will make available the full statistical analysis of the study results following publication if and when required. The results of the study will be submitted for publication in a leading medical/nephrology peer-reviewed journal.