Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Interventions to reduce late referrals to nephrologists.

Fischer MJ, Ahya SN, Gordon EJ. Interventions to reduce late referrals to nephrologists. American Journal of Nephrology. 2011 Jan 1; 33(1):60-9.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

BACKGROUND: Despite the adverse health outcomes with late nephrology referral for patients with chronic kidney disease (CKD), little is known about the underlying mechanisms and reasons for late referral patterns. METHODS: We conducted a Medline search for peer-reviewed articles focused on nephrology referral among adults with CKD. We critically reviewed this literature in regard to late nephrology referral, highlighted its shortcomings, and provided a theoretically based framework for future research. RESULTS: Late referral has been attributed to three key types of factors: primary care provider (PCP), patient, and healthcare system factors. Limited empirical research has pointed to knowledge deficits, perceptions, and preferences by PCPs as well as to knowledge deficits, psychological concerns, and economic concerns by patients. The existing literature is severely limited by retrospective designs, closed-ended surveys, and the absence of a theoretically driven conceptual framework to fully evaluate root causes of this ongoing problem. Social Cognitive Theory may be a particularly well-suited conceptual model for late nephrology referral because important PCP and patient factors correspond to key constructs of this theory. CONCLUSION: Future research is needed to delineate pathways underlying reasons for PCPs' late referral patterns and CKD patients' referral nonadherence. Interventions are urgently needed to reduce late referrals and improve the health of patients with CKD.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.