In this section
@inbook{Wilkinson:2013,
author = {Wilkinson, E and Randhawa, G and Hall, M and Lightstone, L and Farrington, K and Greenwood, R and Roderick, P and Feehally, J},
booktitle = {Global Public Health Policy},
pages = {225--249},
title = {The impact of national chronic kidney disease management guidelines in the United Kingdom on referral patterns for South Asian and european patients with type 2 diabetes mellitus},
year = {2013}
}
TY - CHAP
AB - Background: South Asian patients with type 2 diabetes mellitus in the United Kingdom are over 10 times more likely to progress to end-stage renal disease than European patients. It is unclear whether this is due to late interaction with primary care, late referral to secondary care, suboptimal treatment with protective therapies or increased rates of progression among South Asian patients. This study investigated the demographic and clinical status of South Asian and European patients at the time of referral to renal service, before and after the introduction of national CKD management guidelines. The study also sought to understand patient experiences. Method: A mixed-methods approach was undertaken combining audit and patient interviews. The audit consisted of a retrospective, observational study comparing all South Asian and European patients with type 2 diabetes referred to 4 specialist renal services in the United Kingdom in 2004 and in 2007. Univariate and multivariate analyses were performed. For the patient interviews, newly referred South Asian and White European patients with diabetes over 16 years were recruited from nephrology outpatient clinics in three UK centres - Luton, West London and Leicester. A semi-structured qualitative interview was conducted with 48 patients and a thematic analysis of the data produced is reported. Results: The national audit shows that South Asian patients were younger than European patients at the time of referral (2004: European (E) 70.1±10.5 vs South Asian (SA) 63.0±12.1 years, p<0.001) with less advanced renal disease (2004: eGFR E 40.7±19.6 vs SA 47.3±24.8 ml/min, p=0.006). Following introduction of national CKD guidelines, patients were referred with more advanced renal disease although the decrease in mean eGFR was less pronounced for South Asian patients (2007: eGFR E 32.7±12.4 (- 8.0) vs SA 42.8±23.1 (-4.5) ml/min, p=0.001). These differences were not accounted for by pre
AU - Wilkinson,E
AU - Randhawa,G
AU - Hall,M
AU - Lightstone,L
AU - Farrington,K
AU - Greenwood,R
AU - Roderick,P
AU - Feehally,J
EP - 249
PY - 2013///
SP - 225
TI - The impact of national chronic kidney disease management guidelines in the United Kingdom on referral patterns for South Asian and european patients with type 2 diabetes mellitus
T1 - Global Public Health Policy
ER -