Primary Care Providers’ Experiences Working with Diabetic Patients Who Develop Chronic Kidney Disease

Chronic kidney disease (CKD) is an increasingly prevalent global health threat, with diabetes mellitus (DM) being one of the risk factors for developing CKD. Preventive interventions for DM and CKD have been shown to reduce health care utilization, lower health care costs, and improve the quality of life for individuals with CKD. Patients with DM who do not have early identification of CKD end up requiring renal replacement therapy. The purpose of this general qualitative study was to examine primary care providers’ (PCPs’) experience working with diabetic patients who develop CKD. The research questions addressed how PCPs assess their patients with DM for renal failure, what predictive risk assessment tools (if any) are being used, and what barriers (if any) prevent PCPs from screening patients with DM for CKD. This study was grounded in the integrated screening action model, which supports screening behavior and risk intervention research. A constructivist approach to data collection was used to conduct 10 semistructured virtual interviews with PCPs. Eight themes emerged, including a lack of standardization for screenings and PCPs’ assertion that current guidelines rely on communication and collaboration. Barriers to communication and capacity exist, and there is an opportunity to improve the process by increasing screening activities. PCPs expressed confidence in having risk conversations but noted that ownership of screening execution is a shared responsibility. Findings could inform policies to assist health care providers in caring for patients with DM who develop CKD.