I Need To Treat…

 

You need to choose a treatment for your patient with Chronic Kidney Disease. What are the current treatment options?

If ACE inhibitors and calcium-channel blockers are the best available treatments, which one should the patient be given to slow the progression of CKD?

Outline

  • Review current treatment options for your patient’s condition.
  • Evaluate which treatment option is most appropriate.
  • Apply your knowledge and create a treatment plan for your patient.
What Do You Need To Do?

Calibrate your knowledge of the current treatment options and review treatment information to ensure the best course of treatment for your patient.

Use the PICOT approach to define your unique treatment question when you are searching in the appropriate resource.

Use the available information from Systematic Reviews to connect your treatment question to the clinical context.

 

Why Is This Important?

Creating the habit of assessing your knowledge about treatment options as well as knowing when and where to search for more information will allow you to make informed decisions about the course of treatment best suited for your patient.

How Can You Make These Connections?

Take the following quiz to assess how much you know about CKD treatment options:

Take Quiz

Search the literature to review the potential treatments:

DynaMed Plus or Up-To-Date allows you to quickly identify the general treatment options for chronic kidney disease.

Create your specific treatment question using the PICOT approach:

  1. Patient or population:
  2. Intervention (Treatment 1):
  3. Comparison (Treatment 2):
  4. Outcome:
  5. Timing:

PICOT Example:

  1. Population: Adults age 18-45 years old with CKD
  2. Treatment 1: ACE Inhibitors
  3. Comparison: Placebo
  4. Outcome: Renal Failure
  5. Timing: 5 years

Question – Do adults with CKD age 18-45 years have a lower rate of developing renal failure if they are taking ACE Inhibitors compared to those taking a placebo over a 5 year period?

Search for Systematic Reviews to see which treatment option is best for your unique patient:

Cochrane Library is a database of systematic reviews put together by experts to be used for policy and treatment decisions. Use Cochrane to search for systematic reviews comparing the treatments you are considering for your patient.

PubMed is a biomedical database that can be used to search for systematic reviews. Use PubMed if you are unable to find a systematic review for your treatment options in the Cochrane Library.

Using the Resources

DynaMed Plus

Enter your term in the main search bar – can be the full name or an acronym (you can search for “chronic kidney disease” or “CKD”).

Select the appropriate entry.

Use the menu on the left side of the screen to jump to the appropriate section: General Information, Epidemiology, Treatment, Complications and Prognosis, etc.

DynaMed Plus is available via mobile applications.

Up-To-Date

Enter your term in the main search bar – can be the full name or an acronym (you can search for “chronic kidney disease” or “CKD”).

Select the appropriate entry.

Use the menu on the left side of the screen to jump to the appropriate section: Natural History, Definition and Classification, General Management, Summary and Recommendations, etc.

Up-To-Date is available via mobile applications.

 

Cochrane Library

Enter your terms in the main search bar using appropriate Boolean operators. There are filters to narrow your search on the left hand side of results screen.

Search the results for appropriate systematic reviews that have been written about your topic.

PubMed

On the homepage, use the main search bar to enter your search terms.

Enter your terms using the appropriate Boolean operators (OR, AND, NOT). The results will appear in the next screen.

Apply the Review filter to narrow your results. Search the refined literature for appropriate systematic reviews that have been written about your topic.

 

Note: DynaMed Plus and Up-To-Date are similar clinical point-of-care tools. Try searching in both and see which you prefer using. You may find one more helpful than the other when searching for specific pieces of information, like the epidemiology or natural history of a disease.

For more information please visit the Learning at Your Own Pace tutorials page on the library website – http://library.cumc.columbia.edu/learning-your-pace-tutorials

Review The Important Concepts

The following review activity will test your knowledge of CKD treatment options and the information you learned about in this section:

CKD Treatment Review Activity

Summary

Question yourself! The best way to calibrate how much you know about the treatment options is to ask yourself questions.

Always double check your knowledge! Look for information about the current treatments in DynaMed Plus or Up-To-Date.

Create a treatment question for your unique patient and clinical context using the PICOT strategy.

Use your treatment question as a basis to search the literature for Systematic Reviews in the Cochrane Library or PubMed databases.

Apply the knowledge you found to your unique patient and current clinical context. Make your best decision based on the information you found and your medical training.