Table 1

Topic guide for professional chronic kidney disease (CKD) interviews

QuestionPrompts
CKD
• Can I ask you how CKD is managed in the practice?• Do you mind running through how it works, what happens?
• How do you manage a diagnosis of CKD• How are people with CKD identified?
• What issues do you feel are the most important for people with CKD?• What happens next?
• How is it discussed in consultations?• Are there any examples? Have you recently seen anybody with a diagnosis of early-stage CKD
• (What is your understanding of CKD?)
• Is CKD something that is brought up in consultations?• Is there a practice view on management CKD disclosure — or any differences in practitioners?
• Can I ask how is it brought up?
• Is it possible to know/how do you know what other people are doing in the practice?
• How do you think others (in/outside practice) view the management of CKD?
• Do you always tell patients they have the diagnosis. If yes — how do you tell? If no — how do you decide who to tell? What criteria: who is this discussed with – in the practice, as a team, individual practice … others
• How are people with CKD followed-up?• What is the role of the computers in managing people with (a) vascular conditions; (b) CKD?
• Can I ask what do you think about the QOF register for CKD?• Are there benefits for patients to being on the register?
• Do patients always know they are on a register?
• How is CKD discussed (a) in the practice (e.g. meetings, with other colleagues); (b) in consultations?• What is the role of (insert type of professional) in the management of people with (a) vascular conditions; (b) CKD?
• Is CKD something that is discussed? What gets discussed?• healthcare assistant
If not, are there any reasons for this?• GPs
• Do you have links with specialist services for people with CKD?• other fellow GPs
• Are there any specific recommendations/guidance that the practice has used in the management of people with CKD?• practice nurse
• reception staff
How do you find these recommendations? How has the model/interventions changed practice, the day-to-day management; consultations?• IT
• practice manager
• Is there anything that you feel helps/hinders care?• health trainer
• How is CKD linked to other priorities around vascular care?
• Links to vascular disease: what do you feel are the key issues in the (a) management of people with vascular disease and (b) CKD
Vascular work
• How are people coming in for vascular reviews (such as CHD, blood pressure, stroke) managed in your practice?• What tends to be discussed in consultations with people who have (a) vascular conditions; (b) CKD; (c) other comorbidities?
• What do you feel are the key issues in the management of people with vascular disease?• What happens in your consultations?
• What is the role of (insert type of professional) in the management of people with (a) vascular conditions; (b) CKD?
• Who is involved in the management of people with vascular conditions?
• How does discussion around CKD compare with discussion about other clinical parameters such as hypertension, cholesterol, glycaemic control?• How has care for people with (a) vascular conditions; (b) CKD changed over time?
• Is it possible to know/how do you know what other people are doing in the practice?
Multimorbidity work
• How are people with multimorbidities including CKD managed in (a) the practice; (b) your consultations?
• How does the management of CKD relate to the management of somebody with (a) high blood pressure; (b) heart failure; (c) diabetes; (d) other morbidity?
Illness work
• What do you see as the role of the practice in supporting people in living with (a) vascular conditions; (b) CKD?
• How do people with (a) vascular conditions; (b) CKD navigate their care?
• What would you want an information resource to look like?
• How would it help with the disclosure of CKD?
Demographics
• Age
• Practice size
• Training practice
• Nurse title (practice nurse, nurse practitioner, etc)
• Disease-management clinics (if so, what)
  • CHD = coronary heart disease. CKD = chronic kidney disease.