Dataset Information

Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers.

ABSTRACT:

Background

Treatment protocols for childhood nephrotic syndrome are highly variable between providers and care centres. We conducted a qualitative study to understand the complex multilevel processes that lead to practice variation and influence provider management of nephrotic syndrome.

Methods

Focus groups with multidisciplinary pediatric nephrology care providers (n = 67) from 10 Canadian pediatric nephrology centres that had more than 1 pediatric nephrologist were conducted between September 2013 and April 2015. Focus group discussions were guided by the Ottawa Model for Research Use. We used a semistructured interview guide to elicit participants' perspectives regarding 1) the work setting and context of the clinical environment, 2) reasons for variation at the provider level and 3) clinical practice guidelines for nephrotic syndrome. Focus group discussions were transcribed and analyzed concurrently with the use of qualitative content analysis.

Results

Emerging themes were grouped into 2 categories: centre-level factors and provider-level factors. At the centre level, the type of care model used, clinic structures and resources, and lack of communication and collaboration within and between Canadian centres influenced care variation. At the provider level, use of experiential knowledge versus empirical knowledge and interpretation of patient characteristics influenced provider management of nephrotic syndrome.

Interpretation

Centre- and provider-level factors play an important role in shaping practice differences in the management of childhood nephrotic syndrome. Further research is needed to determine whether variation in care is associated with disparities in outcomes.

SUBMITTER: Samuel SM

PROVIDER: S-EPMC5498309 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Publications

Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers.

Samuel Susan M SM Flynn Rachel R Zappitelli Michael M Dart Allison A Parekh Rulan R Pinsk Maury M Mammen Cherry C Wade Andrew A Scott Shannon D SD

CMAJ open 20170601 2

<h4>Background</h4>Treatment protocols for childhood nephrotic syndrome are highly variable between providers and care centres. We conducted a qualitative study to understand the complex multilevel processes that lead to practice variation and influence provider management of nephrotic syndrome.<h4>Methods</h4>Focus groups with multidisciplinary pediatric nephrology care providers (<i>n</i> = 67) from 10 Canadian pediatric nephrology centres that had more than 1 pediatric nephrologist were condu ...[more]

PMID: 28592406

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Dataset Information

Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers.

Background

Methods

Results

Interpretation

Publications

Factors influencing practice variation in the management of nephrotic syndrome: a qualitative study of pediatric nephrology care providers.

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