Interventions to reduce late referrals to nephrologists

Area of Science:

• Nephrology
• Healthcare Management
• Health Services Research

Background:

• Late nephrology referral is linked to poor health outcomes in chronic kidney disease (CKD) patients.
• Mechanisms and reasons for delayed referrals remain poorly understood.

Purpose of the Study:

• To review existing literature on late nephrology referral in adults with CKD.
• To identify factors contributing to late referrals.
• To propose a theoretical framework for future research.

Main Methods:

• Conducted a Medline search for peer-reviewed articles on nephrology referral in adult CKD patients.
• Critically reviewed literature on late referral patterns and their shortcomings.
• Developed a theoretically based framework for future research.

Main Results:

• Late referral is associated with primary care provider (PCP), patient, and healthcare system factors.
• PCP factors include knowledge deficits and perceptions; patient factors include knowledge deficits, psychological, and economic concerns.
• Existing research is limited by study design and lack of a theoretical framework; Social Cognitive Theory is proposed.

Conclusions:

• Further research is needed to understand PCP and patient factors in late CKD referrals.
• Interventions are crucial to decrease late referrals and enhance CKD patient health outcomes.