让美国的初级医疗服务提供者更容易获得慢性肾病和 2 型糖尿病的治疗指南建议。

Postgraduate medicine Pub Date : 2024-05-01 Epub Date: 2024-05-11 DOI:10.1080/00325481.2024.2350924
Eugene E Wright, Susanne B Nicholas
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引用次数: 0

摘要

管理与 2 型糖尿病(T2D)相关的慢性肾脏疾病(CKD)的临床实践指南旨在通过提供有关这些疾病的筛查、检测、管理和治疗的建议,帮助医疗保健专业人员做出临床决策。然而,初级保健医生(PCPs)在临床实践中例行实施 CKD 和 T2D 指南建议时可能会产生临床惰性。指南制定者已经发布了一系列资源,旨在方便人们获取指南建议,支持初级保健医生在临床实践中高效、一致地实施指南建议。在提供策略以减少初级保健应用指南建议的惰性方面仍存在挑战。在这篇综述中,我们探讨了已发表的循证护理方法在优化 T2D 和慢性肾脏病患者管理方面认知度低、采纳率低的原因。最后,我们就如何在基层医疗机构更好地实施指南建议提出了建议。
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Making treatment guideline recommendations in chronic kidney disease and type 2 diabetes more accessible to primary care providers in the United States.

Clinical practice guidelines for the management of chronic kidney disease (CKD) associated with type 2 diabetes (T2D) are designed to assist healthcare professionals with clinical decision making by providing recommendations on the screening, detection, management, and treatment of these conditions. However, primary care practitioners (PCPs) may have clinical inertia when it comes to routinely enacting CKD and T2D guideline recommendations in their clinical practices. Guideline developers have published a range of resources with the aim of facilitating easier access to guideline recommendations to support efficient and consistent implementation into clinical practice of PCPs. Challenges remain in providing strategies to reduce inertia in the application of guideline recommendations in primary care. In this review, we explore reasons behind the low level of awareness and poor uptake of published evidence-based care approaches to the optimal management of patients with T2D and CKD. Finally, we present suggestions on strategies to improve the implementation of guideline-directed recommendations in primary care.

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