Translating Clinical Research to Clinical Care in Nephrology

Recently, CMEology conducted a study of nephrologists to identify factors that are influential in the translation of research findings into clinical care for patients with autosomal dominant polycystic kidney disease (ADPKD). Participants in the study attended a continuing education activity on ADPKD and volunteered for semistructured interviews exploring their experience translating new knowledge into care for patients with ADPKD.

According to the study, ADPKD is the fourth most common cause of kidney disease in the United States but little is known about the translation of ADPKD research findings into clinical care. Study authors conducted an inductive thematic analysis of interview data to reveal factors that enable the understanding of ADPKD research in clinical care and others that impede the processes. Chief among the challenges faced by clinicians managing patients with ADPKD is the burden of interpreting the clinical research literature, given the lack of official guidelines.

The study noted that there were recurrent themes common to translational science in many areas of medical practice, including the quality and quantity of research, institutional and noninstitutional structural factors, dissemination of findings, practice type, and sociocultural characteristics of the work environment. Some challenges identified in the study included poor comprehension of complex research reports, difficulty with statistics, and the lack of an organizational culture that promotes the uptake of new research results. These factors differed substantially when comparing different practice settings. In academic settings, nephrologists were often in the vanguard of research translation, whereas translation lagged in private and community practices where the demands of patient care responsibilities often impeded the evaluation and implementation of new approaches to ADPKD care.

The study found that, interestingly, there are certain factors that can both enhance or impede research translation. Study authors believe that the influence of those certain factors exists on a continuum and that there is a “tipping point” above and below which promotion will be either more or less effective.

The study notes that CME helps providers learn about recent developments in ADPKD and how to apply findings to clinical care. Additional strategies that can help providers include digital and mobile resources and concise online practice summaries written by credible authors.

In conclusion, the study authors found that various factors were influential in the translation of clinical research into patient care among nephrology providers managing patients with ADPKD. Overall, the thematic analysis helped identify potential educational and noneducational interventions to enhance promoters and mitigate barriers to research translation and that “the same factors can be either promoters or impediments to translation and that understanding the specific considerations that influence this difference in effect—herein referred to as the tipping point—may help in formulating strategies to improve translation in the nephrology setting.”

The findings of this study indicate that education is critical in the translation of ADPKD research to improve the diffusion of innovative practices. “Continuing education is well suited for disseminating new practice and promoting innovation through transformative learning, team-based learning, and simulations as examples,” said Arlene Chapman, MD, Professor of Medicine from the Section of Nephrology, Department of Medicine, and Institute for Translational Medicine at the University of Chicago, Chicago, IL. “More and effective strategies to promote clinical research translation are needed in nephrology, and this study has elucidated important factors in this regard”, she added.

This study was approved by an independent institutional review board. The study was supported in part by a grant from Otsuka America Pharmaceutical, Inc. The funders of this study had no role in study design, collection, analysis, and interpretation of data, writing the report, or the decision to submit the report for publication.

About CMEology
CMEology develops continuing education activities that engage learners and enhance retention. Working with leading institutions, CMEology strives to close professional practice gaps, increase competence, and improve healthcare provider performance. Activities developed by CMEology embrace the National Quality Strategy and are designed to improve the effectiveness of patient care.

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