Original InvestigationPathogenesis and Treatment of Kidney DiseaseImproving Care of Patients With Diabetes and CKD: A Pilot Study for a Cluster-Randomized Trial
Section snippets
Methods
The present is a pilot study performed July 2005 to July 2006 with the intention of collecting information and testing procedures in preparation for a larger cluster-randomized trial. A flow diagram summarizing recruitment and follow-up of physicians and patients is shown in Fig 1. Health care is provided by different systems in Mexico.22 People with the highest purchasing power have access to private medicine (∼3% of the total population). Workers in the formal economy (∼40%) and their nuclear
Results
Forty family physicians were included, 21 in the study group that received the educative intervention and 19 in the control group that did not receive it. In the intervention group, each physician treated 2.2 ± 0.6 patients, whereas in the control group, each physician treated 2.4 ± 0.6 patients. All physicians in the study group attended 90% or more of the training sessions. Age, sex, and labor experience were not different between family physicians of both groups (Table 1).
Discussion
The present study shows for the first time, to the best of our knowledge, that family physicians with adequate training can achieve good preservation of kidney function of patients with DM2. Martínez-Ramírez et al12 showed in a previous study that nephrologists preserved kidney function and improved blood pressure significantly better than family physicians, but this was more remarkable in patients with early nephropathy than overt nephropathy. Because referral of all patients with DM2 and
Acknowledgements
Author affiliations are as follows: Unidad de Investigación Médica en Enfermedades Renales: Laura Cortés-Sanabria, MD, PhD, Alfonso M. Cueto-Manzano, MD, PhD, and Enrique Rojas-Campos, MD, MSc; Dirección de Educación e Investigación, Unidad Médica de Alta Especialidad Hospital de Especialidades, Centro Médico Nacional de Occident: Carlos E. Cabrera-Pivaral, MD, PhD; Unidad de Medicina Familiar (UMF) No. 3: Graciela Barragán, MD; UMF No. 93: Moisés Hernández-Anaya, MD; and Unidad de
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