Right-siting chronic kidney disease care-a survey of general practitioners in Singapore.
BACKGROUND
Chronic kidney disease (CKD) is a major public health problem in Singapore. Efforts are being made to right-site CKD care (stage 1 to 3) from specialist outpatient clinics (SOCs) to general practitioners (GPs) to ease congestion. This study aims to identify factors influencing screening and management of CKD among GPs in Singapore.


METHODS
A survey was conducted among the 1202 GPs between April and September 2010. The survey questionnaire was developed in collaboration with experts in nephrology and general practice, it included questions about screening, awareness and management of CKD.


METHODS
GPs registered with the National Healthcare Group General Practitioner (NHG GP) partner database.


RESULTS
Three hundred and two GPs completed the survey. A total of 70% of the respondents were males and with their median years of practice as 18. A total of 86% of them reported screening for CKD while 50% of GPs were confident of managing patients with CKD stage 1; and 38% of GPs are aware of CKD guidelines. Majority of GPs (64%) agreed that right-siting of early CKD patients would ease congestion at SOCs. Some of the obstacles in CKD management listed by the GPs were lack of patient trust, experience and communication with the specialist and the inability of the patient to pay.


CONCLUSIONS
GPs screen patients for CKD, however their awareness of guidelines is limited. Opportunities exist for improving physician recognition of CKD, awareness of CKD guidelines, improving collaborative care and reimbursement for the patient and the provider. This study has identified factors which when addressed could lead to wider acceptance of CKD right-siting by both the patients and the GPs.
Health Services & Outcomes Research (HSOR), National Healthcare Group, Singapore.
Pradeep P
PP
George
Christina M
CM
Oh
Ping Tyug
PT
Loh
Bee Hoon
BH
Heng
Fong Seng
FS
Lim
D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000628:therapy; D012846:Singapore