Topic: Primary Care
Conditions
Interventions
1. Phase 1:
Systematic review. Focus Group discussions:
1.1. Practitioners groups
1.2. Patients groups
Test data extraction tools & methods
2. Phase 2:
Cluster randomised trial of step-wise anaemia in
Sponsors
Guildford and Waverley CCG
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Phase 1: In-depth discussion Practitioners and patients from four GP practices will be invited to take part in the in-depth discussions. These four GP practices will be purposefully selected on the following criteria: 1. Achievement of Quality Outcome Framework (QOF) points for CKD 2. At least the national average of people aged over 65 years (as CKD particularly affects older people) Phase 2: Clustered Randomised Trial Practice level: 1. GP Practices should be computerised and have had the same computer system for at least 3 years; they should have had laboratory-links (ensuring completeness of pathology results) for this period; and a practice computer system using 5-byte Read codes (commonest used in UK), or Clinical Terms Version 3 (CTv3). 2. Practices have space for the review clinic and consent to participate. Patient level: 1. Adult patients registered with participating practices with CKD (stage 3 and 4) and anaemia (Hb=11g/dl), who are not under the care of a renal physician, and without an obvious other cause for their anaemia (i.e. overt cause of blood loss)
Exclusion criteria
Exclusion criteria: Practice level: 1. Practices with plans to change computer systems during the proposed 3-year study 2. Practices involved in the in-depth group discussions at Phase 1 will be excluded from taking part in Phase 2. Patient level: 1. Patient under 18 years of age 2. Those unable to consent 3. Those receiving dialysis or who have had a renal transplant 4. Those with previous adverse reaction to iron 5. Those currently or previously treated with erythropoietin 6. Those who have expressed a wish to opt out of sharing electronic records to their GP (identifiable by the present of an 'Optout Read codes’: 93C1, or 'Refused consent for upload to local shared electronic record': 9Nd1 in the GP information systems).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The proportion of people with CKD who remain anaemic one year after entry into the study | — |
Secondary
| Measure | Time frame |
|---|---|
| Feasible and acceptable step-wise model of interventions for Phase 2 | — |
Countries
United Kingdom
Outcome results
None listed