Evidence map›Paper›PMID 39304845›Full record

ArticleBMC primary care2024

Guidelines or mindlines? - implementing a new CKD guideline in German primary care.

Konrad Laker, Tim Bothe, Natalie Ebert, Christoph Heintze, Elke Schaeffner, Karen Krüger

Abstract read
In one paragraph

Article in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Konrad LakerInstitute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. konrad.laker@charite.de.ORCID 0009-0009-3452-4180
Tim BotheInstitute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID 0000-0003-4404-2379
Natalie EbertInstitute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID 0000-0002-4463-3315
Christoph HeintzeInstitute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.ORCID 0000-0002-2179-8192
Elke SchaeffnerInstitute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.ORCID 0000-0002-7925-4577
Karen KrügerInstitute of General Practice and Family Medicine, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.ORCID 0000-0001-6331-8727

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe development of clinical guidelines aimed at GPs is a key strategy to improving the management of chronic kidney disease (CKD). In 2019, the first CKD guideline aimed specifically at GPs practicing in Germany was published by the German College of General Practitioners and Family Physicians (DEGAM.)

aimsThe aim of this study is to identify the barriers and enablers for the implementation of this guideline. The results of this project, together with quantitative evaluation against quality indicators for CKD in primary care will inform an update to the guideline.

methodsWe performed 17 semi-structured interviews with GPs practicing in Berlin and Brandenburg. Transcripts were analysed using qualitative content analysis as described by Mayring.

resultsWe found that the perception of low clinical priority of CKD compared to other chronic diseases, opportunity cost of using guidelines, as well as poor patient understanding were significant barriers. GPs expressed that improved graphic design or integration of guideline recommendations in clinical decision support systems were enabling factors. Clinical problems concerning CKD were mostly solved by recourse to informal communication with specialists. GPs reported that they rarely consulted CKD guidelines as an aide to clinical decision making.

conclusionThe most significant barrier to use was that guidelines were not used as step-by-step decision aide in consultations with patients. Our analysis suggests that informal contact between primary and secondary care is significant conduit for evidence-based information on CKD in German primary care. Implementation projects should support the development of these relationships.

Indexed as

Practice Guidelines as TopicPrimary Health CareRenal Insufficiency, ChronicAdultAttitude of Health PersonnelFemaleGeneral PractitionersGermanyGuideline AdherenceHumansInterviews as TopicMaleMiddle AgedPractice Patterns, Physicians'Qualitative ResearchCKDGuidelinesImplementationMindlinesQuality improvement

Identifiers

PMID39304845
PMCPMC11414130

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.