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Understanding the implementation of interventions to improve the management of chronic kidney disease in primary care: a rapid realist review

Overview of attention for article published in Implementation Science, April 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

twitter
13 tweeters

Citations

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42 Dimensions

Readers on

mendeley
147 Mendeley
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Title
Understanding the implementation of interventions to improve the management of chronic kidney disease in primary care: a rapid realist review
Published in
Implementation Science, April 2016
DOI 10.1186/s13012-016-0413-7
Pubmed ID
Authors

Jung Yin Tsang, Tom Blakeman, Janet Hegarty, John Humphreys, Gill Harvey

Abstract

Chronic kidney disease (CKD) is common and a significant marker of morbidity and mortality. Its management in primary care is essential for maintenance of cardiovascular health, avoidance of acute kidney injury (AKI) and delay in progression to end-stage renal disease. Although many guidelines and interventions have been established, there is global evidence of an implementation gap, including variable identification rates and low patient communication and awareness. The objective of this study is to understand the factors enabling and constraining the implementation of CKD interventions in primary care. A rapid realist review was conducted that involved a primary literature search of three databases to identify existing CKD interventions in primary care between the years 2000 and 2014. A secondary search was performed as an iterative process and included bibliographic and grey literature searches of reference lists, authors and research groups. A systematic approach to data extraction using Normalisation Process Theory (NPT) illuminated key mechanisms and contextual factors that affected implementation. Our primary search returned 710 articles that were narrowed down to 18 relevant CKD interventions in primary care. Our findings suggested that effective management of resources (encompassing many types) was a significant contextual factor enabling or constraining the functioning of mechanisms. Three key intervention features were identified from the many that contributed to successful implementation. Firstly, it was important to frame CKD interventions appropriately, such as within the context of cardiovascular health and diabetes. This enabled buy-in and facilitated an understanding of the significance of CKD and the need for intervention. Secondly, interventions that were compatible with existing practices or patients' everyday lives were readily accepted. In contrast, new systems that could not be integrated were abandoned as they were viewed as inconvenient, generating more work. Thirdly, ownership of the feedback process allowed users to make individualised improvements to the intervention to suit their needs. Our rapid realist review identified mechanisms that need to be considered in order to optimise the implementation of interventions to improve the management of CKD in primary care. Further research into the factors that enable prolonged sustainability and cost-effectiveness is required for efficient resource utilisation.

Twitter Demographics

The data shown below were collected from the profiles of 13 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 147 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 147 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 20 14%
Student > Ph. D. Student 19 13%
Researcher 16 11%
Student > Bachelor 15 10%
Student > Doctoral Student 15 10%
Other 32 22%
Unknown 30 20%
Readers by discipline Count As %
Medicine and Dentistry 42 29%
Nursing and Health Professions 27 18%
Social Sciences 10 7%
Psychology 6 4%
Computer Science 5 3%
Other 23 16%
Unknown 34 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 June 2017.
All research outputs
#4,148,344
of 22,860,626 outputs
Outputs from Implementation Science
#832
of 1,722 outputs
Outputs of similar age
#65,482
of 300,360 outputs
Outputs of similar age from Implementation Science
#22
of 45 outputs
Altmetric has tracked 22,860,626 research outputs across all sources so far. Compared to these this one has done well and is in the 81st percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,722 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.7. This one has gotten more attention than average, scoring higher than 51% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 300,360 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 45 others from the same source and published within six weeks on either side of this one. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.