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Implement Sci. 2014 Nov 23;9:169. doi: 10.1186/s13012-014-0169-x.

Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.

Author information

1
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 900 NE 10th Street, Oklahoma City, OK, 73104, USA. james-mold@ouhsc.edu.
2
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 900 NE 10th Street, Oklahoma City, OK, 73104, USA. caspy@cox.net.
3
University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Court, Madison, WI, 53715, USA. Paul.Smith@fammed.wisc.edu.
4
Boonshoft School of Medicine, Wright State University, 3640 Colonel Glenn Highway, Dayton, OH, 45435, USA. therese.zink@wright.edu.
5
Los Angeles Practice-Based Research Network (LA Net), 3940-B East Broadway, Long Beach, CA, 90803, USA. Lyndee.knox@gmail.com.
6
Westat, 1600 Research Boulevard, Rockville, MD, 20850, USA. paulalipman@westat.com.
7
Westat, 1600 Research Boulevard, Rockville, MD, 20850, USA. margotkrauss@westat.com.
8
Westat, 1600 Research Boulevard, Rockville, MD, 20850, USA. bobharris@westat.com.
9
State University of New York at Buffalo, 1315 Jefferson Avenue, Buffalo, NY, 14208, USA. chetfox@gmail.com.
10
HealthPartners Institute for Education and Research, Mail Stop 23301, P.O. Box 1524, Minneapolis, MN, 55440-1524, USA. Leif.I.Solberg@HealthPartners.com.
11
Westat, 1600 Research Boulevard, Rockville, MD, 20850, USA. rachelcohen@westat.com.

Abstract

BACKGROUND:

Four practice-based research networks (PBRNs) participated in a study to determine whether networks could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices.

METHODS:

Motivated practices from four PBRNs received baseline and periodic performance feedback, academic detailing, and weekly practice facilitation for 6 months during wave I of the study. Each wave I practice then recruited two additional practices (wave II), which received performance feedback and academic detailing and participated in monthly local learning collaboratives led by the wave I clinicians. They received only monthly practice facilitation. The primary outcomes were adherence to primary care-relevant process-of-care recommendations from the National Kidney Foundation Kidney Disease Outcomes Quality Initiative Guidelines. Performance was determined retrospectively by medical records abstraction. Practice priority, change capacity, and care process content were measured before and after the interventions.

RESULTS:

Following the intervention, wave I practices increased the use of ACEIs/ARBs, discontinuation of NSAIDs, testing for anemia, and testing and/or treatment for vitamin D deficiency. Most were able to recruit two additional practices for wave II, and wave II practices also increased their use of ACEIs/ARBs and testing and/or treatment of vitamin D deficiency.

CONCLUSIONS:

With some assistance, early adopter practices can facilitate the diffusion of evidence-based approaches to other practices. PBRNs are well-positioned to replicate this process for other evidence-based innovations.

PMID:
25416998
PMCID:
PMC4245828
DOI:
10.1186/s13012-014-0169-x
[Indexed for MEDLINE]
Free PMC Article

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