@article {Scherpbier-de Haane798, author = {Nynke D Scherpbier-de Haan and Gerald MM Vervoort and Chris van Weel and Joz{\'e} CC Braspenning and Jan Mulder and Jack FM Wetzels and Wim JC de Grauw}, title = {Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial}, volume = {63}, number = {617}, pages = {e798--e806}, year = {2013}, doi = {10.3399/bjgp13X675386}, publisher = {Royal College of General Practitioners}, abstract = {Background Chronic kidney disease (CKD) is highly prevalent in patients with diabetes or hypertension in primary care. A shared care model could improve quality of care in these patientsAim To assess the effect of a shared care model in managing patients with CKD who also have diabetes or hypertension.Design and setting A cluster randomised controlled trial in nine general practices in The Netherlands.Method Five practices were allocated to the shared care model and four practices to usual care for 1 year. Primary outcome was the achievement of blood pressure targets (130/80 mmHg) and lowering of blood pressure in patients with diabetes mellitus or hypertension and an estimated glomerular filtration rate (eGFR)\<60ml/min/1.73m2.Results Data of 90 intervention and 74 control patients could be analysed. Blood pressure in the intervention group decreased with 8.1 (95\% CI = 4.8 to 11.3)/1.1 (95\% CI = -1.0 to 3.2) compared to -0.2 (95\% CI = -3.8 to 3.3)/-0.5 (95\% CI = -2.9 to 1.8) in the control group. Use of lipid-lowering drugs, angiotensin-system inhibitors and vitamin D was higher in the intervention group than in the control group (73\% versus 51\%, 81\% versus 64\%, and 15\% versus 1\%, respectively, [P = 0.004, P = 0.01, and P = 0.002]).Conclusion A shared care model between GP, nurse practitioner and nephrologist is beneficial in reducing systolic blood pressure in patients with CKD in primary care.}, issn = {0960-1643}, URL = {https://bjgp.org/content/63/617/e798}, eprint = {https://bjgp.org/content/63/617/e798.full.pdf}, journal = {British Journal of General Practice} }