Post-acute kidney injury (AKI) management in primary care – what works?
A new article from work undertaken by CLAHRC GM (2014-2019) has been published in BMJ Open - reporting the evaluation of a primary care based intervention designed to improve care for people who have had AKI, after they have been discharged from hospital.
The intervention was implemented in NHS Bury CCG and focussed on recording information about AKI on the GP practice system, reviewing the patient’s medication, monitoring their health, and communicating with the patient about AKI.
The study utilised a qualitative process evaluation to understand how the intervention was put into practice, what worked and why. The findings show that recent developments in the primary care workforce were relevant – practice pharmacists successfully played a key role, undertaking medication reviews and coordinating the overall process within practices. Information about AKI episodes received from hospitals (via discharge summaries) was of varying quality – where this was inconsistent or unclear, practice staff spent extra time looking up or interpreting information before they could put the processes of care in place.
This finding links with recent guidance on post-AKI care, published by the Royal College of General Practitioners, which emphasises the importance of having accurate information, when patients are discharged from hospital, and when information is coded within primary care.
The qualitative study was undertaken as part of a wider evaluation of the Bury CCG primary care post-AKI management intervention (which included clinical audit data and a quantitative evaluation). Research on how to improve primary care services, for people who have had AKI, has been limited, therefore, these findings make an important contribution to the evidence base.
BMJ Open Paper:
https://bmjopen.bmj.com/content/10/8/e036077.info
All Bury AKI Reports:
These are available from Bury AKI project pages, within our previous work section of the site - here
For More Information:
Please contact Dr Rebecca Elvey (Rebecca.Elvey@manchester.ac.uk)