RT Journal Article SR Electronic T1 Referring patients with stable moderate-to-advanced chronic kidney disease back to primary care: a feasibility study JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP BJGPO.2021.0177 DO 10.3399/BJGPO.2021.0177 VO 6 IS 2 A1 Carola van Dipten A1 Wim de Grauw A1 Marc ten Dam A1 Willem Assendelft A1 Nynke Scherpbier-de Haan A1 Jack Wetzels YR 2022 UL http://bjgpopen.org/content/6/2/BJGPO.2021.0177.abstract AB 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.