Screening and diagnosis of chronic kidney disease in people with type 2 diabetes attending Australian general practice
Jo-Anne E. Manski-Nankervis A D , Sharmala Thuraisingam A , Phyllis Lau A , Irene Blackberry A B , Janet K. Sluggett C , Jenni Ilomaki C , J. Simon Bell C and John Furler AA Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia.
B John Richards Initiative, La Trobe University, Wodonga, Vic 3690, Australia.
C Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Vic. 3052, Australia.
D Corresponding author. Email: jomn@unimelb.edu.au
Australian Journal of Primary Health 24(3) 280-286 https://doi.org/10.1071/PY17156
Submitted: 2 June 2017 Accepted: 14 February 2018 Published: 29 May 2018
Abstract
Australian guidelines recommend annual screening and monitoring of chronic kidney disease (CKD) in people with type 2 diabetes (T2D). A cross-sectional study utilising data from NPS MedicineWise MedicineInsight program from June 2015 to May 2016 was undertaken to explore: (1) the proportion of patients with T2D attending general practice who have had screening for, or ongoing monitoring of, CKD; (2) the proportion of patients without a documented diagnosis of CKD who have pathology consistent with CKD diagnosis; and (3) the patient factors associated with screening and the recording of a diagnosis of CKD. Of 90 550 patients with T2D, 44 394 (49.0%) were appropriately screened or monitored. There were 8030 (8.9%) patients with a recorded diagnosis of CKD, whereas 6597 (7.3%) patients had no recorded diagnosis of CKD despite pathology consistent with a diagnosis. Older age and diagnosis of hypertension or hyperlipidaemia were associated with increased odds of CKD diagnosis being recorded. Older patients, males, those with recorded diagnoses of hypertension or hyperlipidaemia and those who had their medical record opened more frequently were more likely to be screened appropriately. Screening and monitoring of CKD appears suboptimal. Research to explore barriers to screening, recording and monitoring of CKD, and strategies to address these, is required.
Additional keywords: electronic health records, MedicineInsight, prevalence, recording.
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