TY - JOUR T1 - Referring patients with stable moderate-to-advanced chronic kidney disease back to primary care: a feasibility study JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2021.0177 SP - BJGPO.2021.0177 AU - Carola van Dipten AU - Wim de Grauw AU - Marc ten Dam AU - Willem Assendelft AU - Nynke Scherpbier-de Haan AU - Jack Wetzels Y1 - 2022/05/04 UR - http://bjgpopen.org/content/early/2022/04/29/BJGPO.2021.0177.abstract N2 - Background Care for patients with chronic kidney disease (CKD) necessitates tailored pathways between primary and secondary care. It is unknown if back referring patients with CKD is safe and effective.Aim To study the feasibility of discharging patients with stable moderate-to-advanced CKD from secondary to primary care, and to evaluate quality of care (QoC) and patients’ and GPs‘ experiences.Design & setting A monocentre prospective mixed-method study in the Netherlands.Method Patients were included who met pre-determined back-referral (BR) criteria. Patients were discharged with personalised information guides and transfer letters. GPs had the option of consulting a nephrologist by telenephrology. Renal outcomes, QoC, and experiences were collected after 1 year.Results Eighteen patients were included. The mean age was 73 years; the mean estimated glomerular filtration rate (eGFR) was 33.2 ml/min/1.73 m2 at baseline. After 1 year, four patients had received either no or incomplete monitoring, and one patients’ blood pressure was too high. The remaining 13 had stable eGFR, proteinuria, and metabolic parameters. Patients were satisfied with information provision and treatment by GPs but expected more frequent monitoring. In one-third of cases, monitoring frequency was decreased by GPs for several reasons. GPs believed they had sufficient knowledge to treat patients with CKD, but indicated they needed support besides a transfer letter.Conclusion BR seems safe and feasible for patients with stable moderate-to-advanced CKD who meet specific criteria. Patients have good renal outcomes after 1 year and are satisfied with treatment. GP QoC can be improved, particularly completeness and monitoring frequency. ER -