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Article: The use of oral antidiabetic agents in primary care.

Weekes, Andrew John / Thomas, Merlin C

2007 Volume 36, Issue 6, Page(s) 477–480

Abstract: Background: Guidelines and regulatory documents reflect the potential for chronic kidney disease to impact the efficacy and safety profiles of antidiabetic regimens. We describe the influence of impaired kidney function and its perception by ... ...

Abstract	Background: Guidelines and regulatory documents reflect the potential for chronic kidney disease to impact the efficacy and safety profiles of antidiabetic regimens. We describe the influence of impaired kidney function and its perception by practitioners on the pattern of antidiabetic use in Australian primary care. Methods: Antidiabetic agent prescribing was documented for 3893 patients with type 2 diabetes from the National Evaluation of the Frequency of Renal impairment cO-existing with Noninsulin dependent diabetes mellitus (NEFRON) study. Patients with and without impaired kidney function, identified by their practitioner or defined by an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2, were systematically compared. Results: Most patients received metformin (63%) with sulphonylureas (45%), insulin (13%) and thiazolidinediones (7%) also widely used. Contrary to prescribing guidelines, use of metformin remained frequent (53%) and the proportional usage of sulphonylureas with active metabolites was unchanged in the 23.1% of patients with an eGFR below 60 mL/min/1.73 m2. Even where prescribers identified impaired kidney function in their patients, prescribing of antidiabetic agents was not significantly modified. Discussion: Chronic kidney disease is a common companion to type 2 diabetes in Australia. The move to automated eGFR reporting provides an important opportunity for practitioners to identify impaired kidney function and to improve their management of patients with type 2 diabetes.
MeSH term(s)	Aged ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/drug therapy ; Drug Utilization Review ; Female ; Glomerular Filtration Rate ; Guideline Adherence ; Humans ; Hypoglycemic Agents/administration & dosage ; Hypoglycemic Agents/therapeutic use ; Insulin/therapeutic use ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/diagnosis ; Male ; Metformin/therapeutic use ; Pilot Projects ; Primary Health Care/standards
Chemical Substances	Hypoglycemic Agents ; Insulin ; Metformin (9100L32L2N)
Language	English
Publishing date	2007-06
Publishing country	Australia
Document type	Journal Article
ZDB-ID	423718-3
ISSN	0300-8495
ISSN	0300-8495
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Article ; Online: The management of diabetes in indigenous Australians from primary care

Thomas Merlin C / Weekes Andrew J / Thomas Mark

BMC Public Health, Vol 7, Iss 1, p

2007 Volume 303

Abstract: Abstract Background Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods Diabetes management and outcomes ... ...

Abstract	Abstract Background Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods Diabetes management and outcomes in Indigenous patients enrolled in the NEFRON study (n = 144) was systematically compared with that in non-Indigenous patients presenting consecutively to the same practitioner (n = 449), and the NEFRON cohort as a whole (n = 3893). Results Indigenous Australians with diabetes had high rates of micro- and macrovascular disease. 60% of Indigenous patients had an abnormal albumin to creatinine ratio compared to 33% of non-Indigenous patients (p < 0.01). When compared to non-Indigenous patients, Indigenous patients were more likely to have established macrovascular disease ((adjusted Odds ratio 2.7). This excess in complications was associated with poor glycemic control, with an HbA 1c ≥ 8.0%, observed in 55% of all Indigenous patients, despite the similar frequency use of oral antidiabetic agents and insulin. Smoking was also more common in Indigenous patients (38% vs 10%, p < 0.01). However, the achievement of LDL and blood pressure targets was the same or better in Indigenous patients. Conclusion Although seeing the same doctors and receiving the same medications, glycaemic and smoking cessation targets remain unfulfilled in Indigenous patients. This cross-sectional study confirms Aboriginal ethnicity as a powerful risk factor for microvascular and macrovascular disease, which practitioners should use to identify candidates for intensive multifactorial intervention.
Keywords	Public aspects of medicine ; RA1-1270
Subject code	390
Language	English
Publishing date	2007-10-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: In patients with chronic stable angina, secondary prevention appears better in the very old compared to younger patients: the Coronary Artery Disease in gENeral practiCE (CADENCE) Substudy.

Rajendran, Sharmalar / Visvanathan, Renuka / Tavella, Rosanna / Weekes, Andrew J / Morgan, Claire / Beltrame, John F

Heart, lung & circulation

2013 Volume 22, Issue 2, Page(s) 116–121

Abstract: Background: With our aging communities and the increased prevalence of coronary heart disease (CAD) with age, the impact of this disease in the very old warrants further investigation.: Objective: To assess health outcomes and the attainment of ... ...

Abstract	Background: With our aging communities and the increased prevalence of coronary heart disease (CAD) with age, the impact of this disease in the very old warrants further investigation. Objective: To assess health outcomes and the attainment of guideline-based secondary prevention targets in the very old (>80 years, n=482) as compared to young (<65 years, n=582) and elderly (between 65 and 80 years, n=932) patients, all of whom had chronic stable angina. Design: The coronary artery disease in general practice (CADENCE) study was a cluster-stratified cross-sectional survey. This study reports on health outcomes quantitated using the Seattle Angina Questionnaire and guideline targets achieved for blood pressure, smoking, lipids, diabetic control and body habitus. Settings and participants: 2031 stable angina patients were recruited from 207 primary care practices. Results: Despite similar angina frequency scores, the very old were more physically impaired by their angina than both the young and elderly [76±25 (Young) vs. 70±26 (Elderly) vs. 63±28 (Very old), p<0.05 for both comparisons]. However, the very old had better quality of life scores than young stable angina patients [72±24 vs. 65±25, p<0.05] and were similar to the elderly [72±24 vs. 72±23, p>0.05]. Also blood pressure, lipid, diabetic and body habitus targets were more often achieved in the very old and elderly patients compared to young stable angina patients. Conclusion: Despite similar symptomatic status and greater physical limitations, the very old reported a better quality of life and more often achieved treatment targets than young stable angina patients. Failure to improve secondary prevention measures in younger age groups may potentially contribute to increased morbidity in older age, and failure to achieve 'Healthy Ageing'.
MeSH term(s)	Age Factors ; Aged ; Angina, Stable/epidemiology ; Angina, Stable/physiopathology ; Angina, Stable/prevention & control ; Australia/epidemiology ; Blood Pressure ; Chronic Disease ; Coronary Artery Disease/epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus/blood ; Diabetes Mellitus/epidemiology ; General Practice ; Glycated Hemoglobin A/metabolism ; Humans ; Hypercholesterolemia/blood ; Hypercholesterolemia/epidemiology ; Hypertension/epidemiology ; Hypertension/physiopathology ; Middle Aged ; Obesity/epidemiology ; Practice Guidelines as Topic ; Quality of Life ; Secondary Prevention ; Smoking/epidemiology ; Surveys and Questionnaires
Chemical Substances	Glycated Hemoglobin A ; hemoglobin A1c protein, human
Language	English
Publishing date	2013-02
Publishing country	Australia
Document type	Comparative Study ; Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2012.09.003
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Book: Type 2 diabetes

Thomas, Merlin C / Weekes, Andrew J

from the GP's perspective

2007

Institution	Kidney Health Australia. National Evaluation of the Frequency of Renal impairment cOexisitng with NIDDM
Author's details	Merlin C. Thomas, Andrew J. Weekes
MeSH term(s)	Diabetes Mellitus, Type 2/complications ; Kidney Diseases/complications ; Family Practice
Language	English
Size	59 p. :, ill., ports.
Publisher	Kidney Health Australia
Publishing place	Melbourne
Document type	Book
ISBN	9780646465739 ; 0646465732
Database	Catalogue of the US National Library of Medicine (NLM)

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Article ; Online: The management of diabetes in indigenous Australians from primary care.

Thomas, Mark / Weekes, Andrew J / Thomas, Merlin C

BMC public health

2007 Volume 7, Page(s) 303

Abstract: Background: Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care.: Methods: Diabetes management and outcomes in ... ...

Abstract	Background: Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods: Diabetes management and outcomes in Indigenous patients enrolled in the NEFRON study (n = 144) was systematically compared with that in non-Indigenous patients presenting consecutively to the same practitioner (n = 449), and the NEFRON cohort as a whole (n = 3893). Results: Indigenous Australians with diabetes had high rates of micro- and macrovascular disease. 60% of Indigenous patients had an abnormal albumin to creatinine ratio compared to 33% of non-Indigenous patients (p < 0.01). When compared to non-Indigenous patients, Indigenous patients were more likely to have established macrovascular disease ((adjusted Odds ratio 2.7). This excess in complications was associated with poor glycemic control, with an HbA1c >or= 8.0%, observed in 55% of all Indigenous patients, despite the similar frequency use of oral antidiabetic agents and insulin. Smoking was also more common in Indigenous patients (38%vs 10%, p < 0.01). However, the achievement of LDL and blood pressure targets was the same or better in Indigenous patients. Conclusion: Although seeing the same doctors and receiving the same medications, glycaemic and smoking cessation targets remain unfulfilled in Indigenous patients. This cross-sectional study confirms Aboriginal ethnicity as a powerful risk factor for microvascular and macrovascular disease, which practitioners should use to identify candidates for intensive multifactorial intervention.
MeSH term(s)	Adult ; Aged ; Albuminuria ; Australia/epidemiology ; Continuity of Patient Care ; Creatinine/urine ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/ethnology ; Diabetes Mellitus, Type 2/therapy ; Diabetic Angiopathies/ethnology ; Diabetic Angiopathies/therapy ; Female ; Glycated Hemoglobin A/analysis ; Humans ; Male ; Middle Aged ; Oceanic Ancestry Group/statistics & numerical data ; Odds Ratio ; Patient Care Management ; Primary Health Care/standards ; Primary Health Care/statistics & numerical data ; Risk Factors ; Self Care
Chemical Substances	Glycated Hemoglobin A ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2007-10-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1471-2458
ISSN (online)	1471-2458
DOI	10.1186/1471-2458-7-303
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Disparities between prescribing of secondary prevention therapies for stroke and coronary artery disease in general practice.

Heeley, Emma / Anderson, Craig / Patel, Anushka / Cass, Alan / Peiris, David / Weekes, Andrew / Chalmers, John

International journal of stroke : official journal of the International Stroke Society

2012 Volume 7, Issue 8, Page(s) 649–654

Abstract: Background: Extensive evidence exists regarding the effectiveness of secondary prevention measures in patients with cardiovascular disease.: Aim: We aimed to examine the management and risk perceptions of cardiovascular events in people with ... ...

Abstract	Background: Extensive evidence exists regarding the effectiveness of secondary prevention measures in patients with cardiovascular disease. Aim: We aimed to examine the management and risk perceptions of cardiovascular events in people with established cardiovascular disease. Methods: We analyzed data on 1453 patients, ≥55 year old, with a history of cardiovascular disease, from the Australian Hypertension and Absolute Risk Study. Results: Compared with those 533 patients with stroke/transient ischemic attack, the 743 patients with coronary artery disease were twice as likely to have been prescribed secondary prevention therapies even after adjustment for potential confounding variables (adjusted relative risks 1·85; 95% confidence interval 1·56-2·19, 42% vs. 73% for use of the combination of blood pressure-lowering, lipid-lowering and antiplatelet therapies) and to have better control of lipid and blood pressure levels. General practitioners estimated that only 27% of patients with stroke/transient ischemic attack - 38% of those with coronary artery disease and 41% of those with both conditions - were at a high risk (≥15%) of a recurrent event. Patients similarly underestimated their risk of recurrent cardiovascular events, with only 8% of stroke/transient ischemic attack, 11% of coronary and 15% of combination disease patients rating themselves at 'high' or 'very-high' risk. Conclusions: This study reaffirms the large treatment gap in the uptake of secondary prevention for cardiovascular disease in primary care settings, being much greater for patients with cerebral compared with cardiac cardiovascular disease. This appears to be related to differential perceptions of cardiovascular risk across different vascular territories in both patients and doctors.
MeSH term(s)	Aged ; Antihypertensive Agents/therapeutic use ; Cardiovascular Diseases/complications ; Cohort Studies ; Coronary Artery Disease/prevention & control ; Female ; General Practice/standards ; Healthcare Disparities ; Humans ; Hypolipidemic Agents/therapeutic use ; Male ; Middle Aged ; Myocardial Infarction/prevention & control ; Platelet Aggregation Inhibitors/therapeutic use ; Practice Patterns, Physicians'/standards ; Secondary Prevention ; Stroke/prevention & control
Chemical Substances	Antihypertensive Agents ; Hypolipidemic Agents ; Platelet Aggregation Inhibitors
Language	English
Publishing date	2012-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2303728-3
ISSN	1747-4949 ; 1747-4930
ISSN (online)	1747-4949
ISSN	1747-4930
DOI	10.1111/j.1747-4949.2011.00613.x
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Article ; Online: Simplifying screening for osteoporosis in Australian primary care: the Prospective Screening for Osteoporosis; Australian Primary Care Evaluation of Clinical Tests (PROSPECT) study.

Davis, Susan R / Kirby, Catherine / Weekes, Andrew / Lanzafame, Alfred / Piterman, Leon

Menopause (New York, N.Y.)

2011 Volume 18, Issue 1, Page(s) 53–59

Abstract: Objective: Although bone density by dual-energy x-ray absorptiometry (DXA) is the standard measure for the diagnosis of osteoporosis, as a screening tool, it has significant cost and availability of DXA is not universal. Prospective Screening for ... ...

Abstract	Objective: Although bone density by dual-energy x-ray absorptiometry (DXA) is the standard measure for the diagnosis of osteoporosis, as a screening tool, it has significant cost and availability of DXA is not universal. Prospective Screening for Osteoporosis; Australian Primary Care Evaluation of Clinical Tests (PROSPECT) was a national study undertaken to establish an effective prescreening protocol to be used in primary care facilitating targeted radiological investigation for osteoporosis in older women. Methods: Two hundred sixty-seven primary care physicians recruited 2,466 women 70 years and older who had no previous diagnosis of osteoporosis in a community-based cross-sectional study. The main outcome measures used were lumbar spine and femoral neck T-scores on DXA and presence of a vertebral fracture on thoracolumbar x-ray. Participant characteristics, gap-on-wall occiput test, and rib-to-pelvis distance measurements were provided by each primary care physician. Results: Of the study population, 21.8% (95% CI, 19.9%-23.8%) had osteoporosis of the femoral neck and/or lumbar spine based on DXA, and 24.7% (95% CI, 22.5%-26.9%) had at least one vertebral fracture. Only 7.3% (95% CI, 6.2%-8.3%) had both osteoporosis and radiological vertebral fracture. Univariate and multivariate regression modeling of the demographic and clinical data collected resulted in a three-factor predictive tool for the diagnosis of osteoporosis and/or vertebral fracture that included the following variables: rib-pelvis distance greater than 2 fingerbreadths (yes/no), ever use of estrogen for more than 6 months (yes/no), and body mass index (<25, 25-30, >30 kg/m²). Only screening women classified as moderate to high risk by the tool DXA plus plain x-ray would then result in 14% of women 70 years or older who were not being screened, with 93% of cases being detected. Conclusions: The Prospective Screening for Osteoporosis; Australian Primary Care Evaluation of Clinical Tests tool will contribute to the diagnosis and management of osteoporosis by facilitating targeted screening and hence reducing the need for unnecessary radiology tests at the primary care level.
MeSH term(s)	Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Australia ; Body Mass Index ; Bone Density ; Cross-Sectional Studies ; Estrogens/adverse effects ; Female ; Femur Neck/diagnostic imaging ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/injuries ; Mass Screening/methods ; Multivariate Analysis ; Osteoporosis, Postmenopausal/complications ; Osteoporosis, Postmenopausal/diagnosis ; Osteoporosis, Postmenopausal/diagnostic imaging ; Primary Health Care/methods ; Prospective Studies ; Regression Analysis ; Risk Factors ; Spinal Fractures/etiology ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries
Chemical Substances	Estrogens
Language	English
Publishing date	2011-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	1205262-0
ISSN	1530-0374 ; 1072-3714
ISSN (online)	1530-0374
ISSN	1072-3714
DOI	10.1097/gme.0b013e3181e77468
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Article ; Online: Gender differences in patients with stable angina attending primary care practices.

Dreyer, Rachel / Arstall, Margaret / Tavella, Rosanna / Morgan, Claire / Weekes, Andrew / Beltrame, John

Heart, lung & circulation

2011 Volume 20, Issue 7, Page(s) 452–459

Abstract: Objective: The primary objective of this study was to assess gender differences in the health status of patients with chronic stable angina using the Seattle Angina Questionnaire (SAQ). Potential contributing clinical factors were also examined.: ... ...

Abstract	Objective: The primary objective of this study was to assess gender differences in the health status of patients with chronic stable angina using the Seattle Angina Questionnaire (SAQ). Potential contributing clinical factors were also examined. Methods: Gender disparities in 2005 stable angina patients (712 females) were determined from general practitioner clinical evaluations and patient-completed questionnaire (SAQ). As there were significant age differences between genders, all subsequent analyses were adjusted for age. Results: Compared with men, women with angina had poorer angina-related health outcomes as assessed by the SAQ, including more frequent angina (81±22 vs 85±22, respectively, p<0.001) with greater associated physical limitations (65±27 vs 73±26, respectively, p<0.001) and a poorer quality of life (68±24 vs 71±24, respectively, p=0.0026). Conclusion: Women with stable angina have poorer angina-related health outcomes compared with their male counterparts. Multiple factors may contribute to this disparity including differences in clinical factors, underlying biological mechanisms and psychosocial factors.
MeSH term(s)	Aged ; Aged, 80 and over ; Angina Pectoris/complications ; Angina Pectoris/epidemiology ; Angina Pectoris/psychology ; Chronic Disease ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Primary Health Care ; Quality of Life ; Sex Factors ; Surveys and Questionnaires
Language	English
Publishing date	2011-07
Publishing country	Australia
Document type	Clinical Trial ; Comparative Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2011.02.005
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Article ; Online: The prevalence of vitamin D deficiency and relationship with fracture risk in older women presenting in Australian general practice.

Robinson, Penelope J / Bell, Robin J / Lanzafame, Alfred / Kirby, Catherine / Weekes, Andrew / Piterman, Leon / Davis, Susan R

Australasian journal on ageing

2013 Volume 32, Issue 3, Page(s) 177–183

Abstract: Aim: To investigate vitamin D status among older women and to explore relationships between vitamin D and fracture risk and vertebral fractures.: Methods: A total of 267 general practitioners recruited 2466 women aged >70 years with no known ... ...

Abstract	Aim: To investigate vitamin D status among older women and to explore relationships between vitamin D and fracture risk and vertebral fractures. Methods: A total of 267 general practitioners recruited 2466 women aged >70 years with no known osteoporosis or fragility fracture. Serum 25-hydroxy vitamin D (25(OH)D), bone mineral density by dual-energy X-ray absorptiometry (DXA) and vertebral fracture on thoracolumbar X-ray were determined. Results: A total of 2368 women, median age 76 years, provided data and of these 13% were on vitamin D supplements. 25(OH)D levels were available for 907 (44.1%) of those not taking vitamin D. 88.3% of these had a level below 75 nmol/L. Serum 25(OH)D was negatively associated with age (P = 0.003) and body mass index (P < 0.001), and positively associated with lower latitude, femoral neck DXA T-score (P = 0.044) and being Caucasian (P < 0.001). Conclusions: The vitamin D status of community-dwelling older Australian women is inadequate, yet the use of supplements is low.
MeSH term(s)	Absorptiometry, Photon ; Aged ; Aged, 80 and over ; Australia/epidemiology ; Biomarkers/blood ; Bone Density ; Dietary Supplements ; Female ; Femur Neck/diagnostic imaging ; General Practice ; Humans ; Linear Models ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/injuries ; Multivariate Analysis ; Osteoporosis/diagnostic imaging ; Osteoporosis/epidemiology ; Osteoporosis/prevention & control ; Osteoporotic Fractures/diagnostic imaging ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/prevention & control ; Prevalence ; Risk Factors ; Sex Factors ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/epidemiology ; Spinal Fractures/prevention & control ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/injuries ; Vitamin D/analogs & derivatives ; Vitamin D/blood ; Vitamin D/therapeutic use ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/diagnosis ; Vitamin D Deficiency/drug therapy ; Vitamin D Deficiency/epidemiology
Chemical Substances	Biomarkers ; Vitamin D (1406-16-2) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2013-09
Publishing country	Australia
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1457406-8
ISSN	1741-6612 ; 0726-4240 ; 1440-6381
ISSN (online)	1741-6612
ISSN	0726-4240 ; 1440-6381
DOI	10.1111/j.1741-6612.2011.00553.x
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Article: The assessment of kidney function by general practitioners in Australian patients with type 2 diabetes (NEFRON-2).

Thomas, Merlin C / Weekes, Andrew J / Broadley, Olivia J / Cooper, Mark E

The Medical journal of Australia

2006 Volume 185, Issue 5, Page(s) 259–262

Abstract: Objective: To examine factors influencing the identification of kidney impairment in patients with type 2 diabetes in Australian primary care.: Design, setting and participants: 348 general practitioner investigators were asked to estimate kidney ... ...

Abstract	Objective: To examine factors influencing the identification of kidney impairment in patients with type 2 diabetes in Australian primary care. Design, setting and participants: 348 general practitioner investigators were asked to estimate kidney function and its severity in 10-15 consecutively presenting patients with type 2 diabetes (n = 3893). They were then asked, for each patient, whether they routinely estimated kidney function. No instruction was provided on how kidney function should be estimated or categorised. Data were collected between April and September 2005. Main outcome measures: Kidney function estimated by the Cockcroft-Gault equation using clinical and laboratory data provided by the GP; estimates of kidney function made by the GP. Results: In 24% of the patients with type 2 diabetes, their GP routinely estimated kidney function. However, few of these patients had impaired kidney function or risk factors for kidney disease. There was a good statistical correlation between the estimates made by GPs and the data-derived estimates (R2 = 0.72). GPs identified patients with data-derived estimates of kidney function < 60 mL/min in over 83% of cases, with a specificity of 90%. Impaired kidney function was reported by GPs in 34.4% of men and 36.4% of women. These figures were discordant with function categorisation using both GP estimates and data-derived values, overlapping in half of the patients. Despite GPs' ability to assess creatinine clearance, "raw" (unstandardised) serum creatinine levels inappropriately influenced the perception of impairment of kidney function. Conclusion: GPs can accurately assess kidney function, without reporting of estimated glomerular filtration rate (eGFR). However, even in patients at increased risk of chronic kidney disease, routine estimates are seldom made. Our findings underline the value of the recent initiative recommending automatic reporting of eGFR in Australia.
MeSH term(s)	Aged ; Australia ; Clinical Competence ; Creatinine/blood ; Diabetes Mellitus, Type 2/complications ; Diabetic Nephropathies/physiopathology ; Family Practice/standards ; Female ; Humans ; Kidney Function Tests ; Male ; Practice Patterns, Physicians'/statistics & numerical data ; Reproducibility of Results
Chemical Substances	Creatinine (AYI8EX34EU)
Language	English
Publishing date	2006-01-23
Publishing country	Australia
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	186082-3
ISSN	1326-5377 ; 0025-729X
ISSN (online)	1326-5377
ISSN	0025-729X
DOI	10.5694/j.1326-5377.2006.tb00556.x
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