The Cornish Experience Of The ASSIST-CKD Project

Introduction: The ASSIST-CKD project is a national quality improvement program, aiming to decrease the number of patients presenting late to Renal services by empowering laboratories to review up to 5 years of eGFR results graphically, and report deteriorating patients to their GP. Aim: To assess the impact of the project on the laboratory, and patient reporting on GP management and the local Renal service. Method: Each week two searches were performed (Search A: Max age 65 years, max eGFR 50 ml/min/1.73m2 and Search B: Age 66-120 years, max eGFR 40 ml/min/1.73m2) on patients with an eGFR requested by their GP within the last seven days. Patients showing deterioration in eGFR had a printed graph-report sent to their GP. Feedback on the graph-reports and their impact on patient management were obtained from the GPs via a questionnaire. Results: A median of 37 patients/week were listed for review for Search A, with 32% being reported; and Search B a median of 227 patients/week listed, 32% being reported. Twenty-nine GP surgery questionnaires were reviewed and showed the reports were well received. Sixty-seven percent of GPs responding to the questionnaire had reviewed a patient earlier than intended, 54% had reviewed local guidance, 48% had emailed the Renal team and 48% had referred a patient on receipt of a graph-report. Thirty-four percent had shown a graph-report to their patient, and 70% found that useful. Conclusion: Already there are tentative signs that ASSIST-CKD reporting has enhanced patient care; however, further long-term assessment is still required.