Indicator Details: Percentage of Physicians Reporting that Clinical Guidelines Influence Their Treatment of CKDa
Data Sources
 
Stratification and Year Choices:

  Source
  • NKDEP

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Published literature or one-time analysis, ongoing surveillance not available Published literature or one-time analysis, ongoing surveillance not available

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Footnotes:
a Adapted from Lea et al. (2006).




The majority of surveyed primary care physicians report using guidelines from the American Diabetes Association (79%) and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (78%) in treating CKD; but only 22% reported using the CKD-specific National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines.
Chart Explanation: Nearly 80% of primary care physicians are familiar with and influenced by the American Diabetes Association and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure guidelines for treatment of CKD. However, only about one in five primary care physicians (22%) used the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines, although it should be noted that these guidelines were published in 2002, only 1 year before the survey was conducted.
In 2003, the National Kidney Disease Education Program (NKDEP) conducted a telephone survey of 464 primary care physicians in six primarily African-American communities (Atlanta, GA; Baltimore, MD; Cleveland, OH; New Orleans, LA, St. Louis, MO; Memphis, TN). Due to inclusion criteria, the participants may not respresent the average primary care physician in terms of patient population or level of CKD knowledge.

The 2003 NKDEP physician survey of 464 primary care physicians (7.6% response rate) in six primarily African-American communities (Atlanta, GA; Baltimore, MD; Cleveland, OH; New Orleans, LA, St. Louis, MO; Memphis, TN) (Lea, McClellan, Melcher, Gladstone, & Hostetter, 2006) included physicians identifying family practice, general practice, or general internal medicine as their specialty and patient populations that were at least 20% diabetic and/or hypertensive. The survey consisted of asking the physician: “Please indicate how much you believe the following risk factors increases a patient’s risk for CKD, ie, CKD or chronic renal insufficiency?,” with possible responses of “does not increase risk,” “slightly increases risk,” “moderately increases risk,” or “greatly increases risk.” Risk factors included African-American race/ethnicity, family history, diabetes mellitus, and hypertension. Additionally, physicians were asked: “Of the following guidelines, which have influenced your practices and procedures for treatment of CKD?,” with possible responses of “yes” or “no” to guidelines including the American Diabetes Association (ADA) Position Statement on Nephropathy, the Sixth Joint National Committee Report (JNC-VI), and the Kidney Disease Outcomes Quality Initiative (KDOQI).
FieldData
Description of MeasureKnowledge of CKD risk factors among primary care physicians
Data SourceNational Kidney Disease Education Program
Type of Data SourcePrivate
Data SetSurvey results
Health Care System DataNo
Regional or National?Regional
Demographic GroupPrimary care physicians (family practitioner, general practitioner, or general internal medicine specialist) with ≥20% diabetic and/or hypertensive patients
NumeratorResponding physicians indicating risk factor as increasing CKD risk for patients
DenominatorAll responding physicians
Primary Data Source IndicatorProportion of physicians surveyed who identified risk factor as “moderately” or “greatly” increasing CKD risk
Primary Indicator Method of MeasurementSurvey (office telephone survey)
Frequency of Measurement (Primary)Once (cross-sectional)
U.S. Region Covered by Primary Variable6 predominantly African-American communities (Atlanta, GA; Baltimore, MD; Cleveland, OH; New Orleans, LA, St. Louis, MO; Memphis, TN)
Period Currently Available2003
Pending DataUnknown
Additional Data Items of InterestKnowledge of clinical guidelines
Limitations of IndicatorUrban physicians only in predominantly African-American communities; low response rate (7.6%), limiting generalizability
Analytical ConsiderationsCategories lumped due to small groups/missing responses
References and Sources:
  • Lea JP, McClellan WM, Melcher C, Gladstone E, Hostetter T. CKD risk factors reported by primary care physicians: do guidelines make a difference? Am J Kidney Dis. 2006;47(1):72-7.
    http://www.ncbi.nlm.nih.gov/pubmed/16377387
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd