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Primary care providers including General Practitioners (GPs), are the main point of care for patients with CKD.1 CKD affects 1 in 7 people, with over 90% of people unaware that they have the condition. As it is a silent disease and stages 1-4 of CKD are asymptomatic, it is vital for GPs and primary care providers to play a key role in the detection and management of CKD. A previous online learning activity developed by Kidney Health Australia encouraged GPs to conduct a clinical audit of their practice to identify patients with CKD. This activity follows on to encourage GPs to ensure their patients who have been diagnosed with CKD are receiving optimal treatment following Guideline Directed Medical therapies (GDMT).

Guideline Directed Medical Therapies (GDMT) is an evidence-based approach aimed at reducing morbidity and mortality aassociated with chronic health conditions and was first created in the 2013 ACFF/AHA Guideline for the Management of Heart Failure to describe optimal medical therapy. In the case of CKD, optimal pharmacotherapies can slow the progression of CKD by up to 15 years, and potentially longer if started early. In addition to pharmacological therapies, the Australian Chronic Kidney Disease (CKD) Management in Primary Care handbook recommends a range of interventions including management of blood pressure, lifestyle measures, and consideration of diabetes and heart disease as part of GDMT for CKD.

Despite established guideline recommendations for the management of CKD, uptake of GDMT is low. Only 25% of people with CKD receive ‘complete monitoring’ in Australian primary care. For example, SGLT2 inhibitors reduce the risk of kidney failure and death in patients with CKD, however data from general practices in Australia found that use in eligible patients was low. Only 4.1% of patients with CKD received a SGLT2 inhibitor, despite 44.2% being eligible for treatment. This online learning activity will encourage GPs to review their patients with CKD to identify whether they are receiving GDMT and to reflect on changes that could be made to improve the management of CKD in their practice.

Learning Outcomes

1. Describe the key components of Guideline Directed Medical Therapies for the management of CKD in Australia
2. Identify two patients who have CKD and use the CKD-Go app or website for a colour coded clinical action plan to review current treatment
3. Assess whether the two identified patients are following GDMT for CKD and what changes could be made to their current management
4. Review current systems for flagging whether Guideline Directed Medical Therapies are being considered for patients with CKD and options for recalling patients for potential changes to their current management
5. Develop a whole of practice plan to use the colour coded clinical action plans for following GDMT for patients with CKD
6. Integrate an ongoing review process to monitor the effectiveness of the whole of practice plan.

Details

Enquiries: primary.care@kidney.org.au

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