Primary Care Provider Adherence to the Canadian Diabetes Association Clinical Practice Guideline for Chronic Kidney Disease

Background: Diabetes mellitus is the leading cause of chronic kidney disease (CKD) requiring dialysis and contributes to one-half of all new dialysis cases each year in Canada. Despite the ability to stop or slow the progression of CKD through early detection and intervention, CKD continues to rise, in part, due to providers’ lack of knowledge of and adherence to established national clinical practice guidelines (CPGs). Methods: A quality improvement project was implemented in a rural, primary care clinic to enhance provider knowledge of the current CPG recommendations for CKD screening before and after a provider-specific educational intervention. Results: The educational intervention improved provider knowledge of and confidence in screening for renal disease in diabetic patients. The average numbers of diabetic patients screened for renal disease improved each year, with 85.5% being screened in 2015-2016, resulting in a net increase of 31.5%. In addition, modifiable risk factor screening by providers also improved in the same period, including measures of weight, blood pressure, lipids, and glycosylated hemoglobin levels. Conclusion: Increasing primary provider awareness and knowledge, through education, can foster early recognition and management of CKD in diabetes and ultimately improve renal health outcomes in the diabetic population