Primary Care Provider Education and Computer-Based Tools for Improving Confidence in CKD Management: A Literature Review

Abstract

Background: Chronic kidney disease (CKD) is a global health burden that affects upwards of 13.4% of the population and costs health systems billions annually. Guidelines to identify and manage CKD have been published for over twenty years. Thus finding effective interventions to stem this global health burden is an essential focus of current research. Objective: This literature review attempts to answer the question: Do interventions directed to primary care providers such as education, awareness of clinical practice guidelines, and electronic clinical decision support tools improve the confidence that PCPs have in managing and caring for CKD patients? Methods: A literature search of PubMed, CINAHL, and SCOPUS databases using the key terms ‘CKD’, ‘chronic kidney disease’, ‘PCP’, ‘primary care provider’, and ‘education’ was performed. Results were limited to articles within the past decade and included only randomized controlled trials to maintain the power of results. Results: Five articles met the criteria for inclusion in this literature review, with a further two articles included after reviewing reference lists. The seven articles included in this review employed a variety of primary care provider educational interventions and several system-level computerized interventions using electronic patient record systems. Conclusion: Despite various interventions to assist with adopting previously published guidelines in both educational and system-level spheres, minimal impact on the confidence level of primary care physicians and impact on those living with CKD was observed. Implementation of integrated and interdisciplinary interventions may be necessary for evaluation in future studies.