RT Journal Article
SR Electronic
T1 Understanding risk stratification of chronic kidney disease: a qualitative study in primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP BJGP.2025.0802
DO 10.3399/BJGP.2025.0802
A1 Veighey, Kristin
A1 Teasdale, Emma
A1 Myall, Michelle
A1 Henaghan-Sykes, Kate
A1 Blakeman, Thomas
A1 Ibrahim, Kinda
A1 Raut, Bhargav
A1 Everitt, Hazel
A1 Fraser, Simon DS
YR 2026
UL http://bjgp.org/content/early/2026/08/23/BJGP.2025.0802.abstract
AB Background Chronic kidney disease (CKD) affects approximately 10% of adults in England. Of these adults, approximately 1% progress to kidney failure with a significant impact on health-related quality of life and high healthcare costs. CKD is associated with increased cardiovascular disease risk. New therapies to improve outcomes highlight the need for effective risk stratification.Aim To explore primary care teams’ views and experiences of CKD risk stratification.Design and setting Qualitative interview and focus group study with GP practices in South England, South London, and Yorkshire.Method Twenty-six semi-structured interviews with GPs, pharmacists, and practice nurses, and four focus groups (31 participants) with practice teams including clinical, administration, and management staff were undertaken between January 2024 and January 2025 across 20 practices, informed by normalisation process theory, using thematic analysis.Results We identified four key themes: 1) awareness of diagnostic criteria and risk- stratification tools, 2) value of coding CKD and discussion of risk, 3) barriers to CKD risk stratification, 4) improving CKD risk stratification. Despite universal awareness of diagnostic criteria, there was low awareness of risk-stratification tools. Coding was perceived as valuable for health professionals but not for patients. Concerns included increasing patient anxiety and overmedicalisation. Time pressures and lack of incentivisation were perceived as key barriers. Improved healthcare professional education, guidelines, pathways, and technology/automation were highlighted as areas of potential improvement.Conclusion Primary care awareness of CKD is high, but workload, time pressures, and concerns regarding patient anxiety/overmedicalisation may contribute to incomplete risk stratification. Refining processes and effective patient communication could improve care.