Appendix 8The semistructured interview guide used for general practitioner telephone interviews
Topic guide for general practitioner structured telephone interviews
A. Seeing chronic kidney disease patients in practice
Can you tell me what experience you have in managing patients who have chronic kidney disease? And patients who have kidney failure?
Can you tell me a little bit about patients with chronic kidney disease stage 5 that you currently look after or that you have looked after most recently?
How old? What comorbidities? Seen how often? For what?
For patients with kidney failure, where are they in terms of management? (e.g. transplant, on dialysis, likely to be on dialysis in the future, conservative care)
Can you tell me approximately how many patients you have seen with established kidney failure in the last 6 months?
How often would you/your practice tend to see patients with CKD stage 5?
B. Referring chronic kidney disease patients to secondary care
How would your practice normally identify patients with chronic kidney disease or kidney failure? What is the most common way kidney disease is identified?
If you identified a patient with new CKD5 what action(s) would you/your practice routinely take?
Can you tell me about a time when you told someone they had chronic kidney disease? How did you tell them? What words did you use? What about stage 5?
What questions do patients have about CKD? What do they think of when they are told?
What proportion of the patients, with CKD5, on your practice list get referred to secondary care?
What are the reasons for referral?
What are the reasons for non-referral?
Do you have any guidelines about when to refer? National or local?
How is referral to secondary care discussed with the patient?
How is non-referral to secondary care discussed with the patient?
Do you notify the renal unit about patients who are not being referred? How? What is their reaction?
If a patient is not referred, how is this recorded in their notes? (e.g. secondary care if admitted to hospital).
C. Managing patients with stage 5 chronic kidney disease
What role do you as a GP play in the management of CKD5 patients who are under nephrology?
Do you have a systematic approach to following-up patients with chronic kidney disease?
What are the components of patient care if they are not under nephrology?
How do you feel about CKD5 patients being referred back to primary care if they opt not to have active treatment/opt for conservative treatment?
What agencies/health care professions are involved in CKD management/treatment? How were those connections made? GP referral?
How are the palliative care needs of CKD5 patients addressed?
Do you have any concerns about managing CKD patients? Do you think you need any training in managing CKD? Would you like any training?
What, in an ideal world, would you like to see happen with the management of these patients? What role would GPs play? What are the barriers to achieving this?
Conclusion
Are there any other relevant issues we haven’t covered that you would like to mention?
Are there any questions you that would like to ask me?
Demographic questions
Gender.
Age.
Years in practice.
Years in current surgery.
Special interests (e.g. kidney disease, palliative care, care of the elderly).
