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Table 3 Barriers to diagnosis and management of CKD in primary care, as reported in included studies (studies listed by reference number)

From: Barriers and enablers to detection and management of chronic kidney disease in primary healthcare: a systematic review

 [22][7][32][29][30][23][8, 34][33][24][5, 36][25][31][6][9][26][27][37][10][35][28]
Beliefs about capabilities
 Challenges educating patients       X          X 
 Challenging nature of CKD management      X        X X  
Beliefs about consequences
 Cost and/or burden for patients   X  X             
 Fear of frightening patients with diagnosisXXX    XX   XXX  XX 
 Lower priority of CKD as a clinical issueXX     X   X X    X 
 Perception that kidney decline is to be expected in aging XX         X     X 
 Reactive focus to healthcare         X          
Environmental context and resources
 Challenges using laboratory measures for CKD diagnosis or management  X   X    X        
 Inadequacy of reporting process to support quality improvement                   X
 Lack of patient education resources      XX        X   
 Lack of renumeration for CKDX            X      
 Limited access to nephrology      X  X      X X 
 Technological issues   X    X          X
 Time/workloadX XXX XX   XXXXX  XX
 Variation in practice styleX                   
 Dissatisfaction with guidelines  X   X X XXX  X XXX
 Lack of awareness of guidelines  XX  X            X
 Lack of awareness of resources/support services               XX   
 Perceived lack of adequate knowledge or training  X   X      X XXXXX
 Perceived lack of clear definition of CKD                  X 
Perceptions about patients
 Lack of patient understanding of CKD    X XX         X  
 Perceived low patient adherence  X X    X X       X
Social influences
 Poor communication between healthcare providers    X X  X     XX X 
Social/professional role and identity
 Lack of clear role delineation between healthcare providers X X  X  X X   X    
 Perception of role by other healthcare providersX    XX  X   X    X 
 Patient perception of roles of healthcare provider/s    X X      X