BACKGROUND: Although primary care physicians (PCPs) are often responsible for the routine care of older adults with @entity740 ( @entity740 ), there is a paucity of evidence regarding their perspectives and practice of conservative (non-dialysis) care. We undertook a qualitative study to describe barriers, facilitators and strategies to enhance conservative, non-dialysis, @entity740 care by PCPs in the community. METHODS: Semi-structured telephone and face-to-face interviews were conducted with PCPs from Alberta, Canada. @entity1 were identified using a snowball sampling strategy and purposively sampled based on sex, age and rural/urban location of clinical practice. Eligible @entity1 had managed at least one @entity1 >= 75 years with Stage 5 @entity740 (estimated glomerular filtration rate <15 mL/ @entity1009 .73 m(2), not on dialysis) in the prior year. @entity1 recruitment ceased when data saturation was reached. Transcripts were analyzed thematically using conventional content analysis. RESULTS: In total, 27 PCPs were interviewed. The majority were male (15/27), were aged 40-60 years (15/27) and had practiced in primary care for >20 years (14/27). Perceived barriers to conservative @entity740 care included: managing expectations of @entity177 for @entity1 and their families; dealing with the complexity of medical management of @entity1 requiring conservative care; and challenges associated with managing @entity1 jointly with specialists. Factors that facilitated conservative @entity740 care included: establishing @entity1 /family expectations early; preserving continuity of care; and utilizing a multidisciplinary team approach. Suggested strategies for improving conservative care included having: direct telephone access to clinicians familiar with conservative care; treatment decision aids for @entity1 and their families; and a conservative care clinical pathway to guide management. CONCLUSIONS: PCPs identified important barriers and facilitators to conservative care for their older @entity1 with Stage 5 @entity740 . Further investigation of potential strategies that address barriers and enable facilitators is required to improve the quality of conservative care for older adults in the community.

Primary care physicians' perceived barriers, facilitators and strategies to enhance conservative care for older adults with XXXX : a qualitative descriptive study.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'Participant', 'Participants'] @entity177 :: ('MESH:D051437', 'Disease') :: ['kidney failure'] @entity1009 :: ('966', 'Gene') :: ['min/1'] @entity740 :: ('MESH:D051436', 'Disease') :: ['CKD', 'chronic kidney disease']
@entity740 :: (MESH:D051436,Disease) :: ['chronic kidney disease']
