Multidisciplinary proactive e-consults to improve guideline-directed medical therapies for patients with diabetes and chronic kidney disease: an implementation study
Authors' conclusion
MPE was an acceptable and appropriate health system strategy to identify and address gaps in GDMT among patients with T2D and CKD. Adopting MPE could enhance GDMT, though PCPs raised feasibility concerns which could be improved with program enhancements, including follow-up e-consults for reinforcement, and administrative support for navigating system-level barriers.
Study context
- Population
- Primary care provider (PCP)–patient dyads, patients with T2D and chronic kidney disease (CKD), academic health system
- Participants
- 20 PCPs
- Outcome
- Feasibility, acceptability and appropriateness of MPE (qualitative themes)
Methodological detailsmixed methods: in-depth interviews with iterative qualitative analysis, EHR prescription data, academic health system
- Mixed methods: in-depth interviews with iterative qualitative analysis
- EHR prescription data
- Academic health system
Main finding
As reported in the abstract
- Interviewed: 16 PCPs and 2 specialists
- Themes: appropriateness of prioritising GDMT for T2D and CKD; acceptability of recommendation content; PCP characteristics impact experience with MPE; acceptability and appropriateness of multidisciplinary collaboration; feasibility of MPE to overcome patient-specific barriers to GDMT; appropriateness of workflow
Further findings
| Outcome | Values |
|---|---|
| Newly prescribed SGLT2i · 6 months postbaseline | MPE 39% |
| RAASi newly prescribed or dose increased · 6 months postbaseline | MPE 39% |
- Newly prescribed SGLT2i: n=18 patients
- Renin-angiotensin-aldosterone system inhibitors (RAASi) newly prescribed or dose increased: n=18 patients
Original publication
Multidisciplinary proactive e-consults to improve guideline-directed medical therapies for patients with diabetes and chronic kidney disease: an implementation study. BMJ Open Diabetes Res Care. Published 6 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →