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PREPARING PATHWAYS TO MANAGE MLTCs IN PRIMARY CARE

Total questions: 111

Worksheet time: 56mins

Name
Class
Date
1.

  1. 1. Hypertension
    1.1. Screening for hypertension in eligible patients 
    1.1.1. How high would you prioritise implementing the following two recommendations for hypertension screening in your clinical setting?
    Screening all patients once in 5 years

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
2.


  1. 1.1.1. How high would you prioritise implementing the following two recommendations for hypertension screening in your clinical setting?
    Annual screening of patients with diabetes

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
3.

1.1.2. How feasible would it be to implement the recommendation of hypertension screening process?
Screening all patients once in 5 years

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
4.

1.1.2. How feasible would it be to implement the recommendation of hypertension screening process?
Annual screening of patients with diabetes

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
5.
1.1.3. Do you have any comments?
4 lines
6.

1.2. Diagnosis of Hypertension
1.2.1. How high would you prioritise implementing the recommendations for the process of diagnosing hypertension in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
7.
1.2.2. How feasible would it be to improve the implementation of the above recommendations in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
8.
1.2.3. Any comments?
4 lines
9.

1.3. Grading of Hypertension
1.3.1. How would you prioritise recommendations to grade hypertension in your clinical setting ?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
10.
1.3.2. How feasible would it be to implement recommendations to grade hypertension in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
11.
1.3.3. Any comments?
4 lines
12.

1.4. Cardiovascular risk assessment
1.4.1. How high would you prioritise recommendations to the calculation of the cardiovascular risk in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
13.
1.4.2. How feasible would it be to implement recommendations to the calculation of the cardiovascular risk in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
14.
1.4.3. Any comments?
4 lines
15.

1.5. Investigating a patient with hypertension
1.5.1. How high would you prioritise recommendations to perform initial investigations at the diagnosis of hypertension in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
16.

1.5. Investigating a patient with hypertension
1.5.1. How high would you prioritise recommendations to perform initial investigations at the diagnosis of hypertension in your clinical setting?

Recommendations to performing only the basic investigations

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
17.

1.5.1. How high would you prioritise recommendations to perform initial investigations at the diagnosis of hypertension in your clinical setting?

Recommendation performing other investigations

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
18.

1.5.2. How feasible would it be to implement recommendations to perform initial investigations at the diagnosis in your clinical setting?
Recommendations to perform basic investigations

a)

1 Not feasible at all

b)
2
c)
3
d)
4
e)

5 Very feasible

19.

1.5.2. How feasible would it be to implement recommendations to perform initial investigations at the diagnosis in your clinical setting?
Recommendations to perform other investigations

a)

1 Not feasible at all

b)
2
c)
3
d)
4
e)

5 Very feasible

20.
1.5.3. Any Comments
4 lines
21.

1.6. Education regarding lifestyle modification
1.6.1. How high would you prioritise recommendations to provide education on lifestyle modifications in hypertension management in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
22.
1.6.2. How feasible would it be to implement recommendations to educate on lifestyle modifications in hypertensive management in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
23.
1.6.3. Any comments?
4 lines
24.

1.7. Prescribing of antihypertensive medication
1.7.1. How high would you prioritise recommendations to prescribe appropriate antihypertensive medication according to the algorithms, in your clinical setting ?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
25.
1.7.2. How feasible would it be to implement recommendations to prescribe antihypertensive medications in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
26.
1.7.3. Any comments?
4 lines
27.

1.8. Follow up after initial assessment
1.8.1. How high would you prioritise recommendations to schedule the frequency of follow up after the initial assessment in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
28.
1.8.2. How feasible would it be to implement recommendations to arrange follow up schedule in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
29.

1.8.3. Any comments?

4 lines
30.

1.9. Assessment of Hypertension Mediated Organ Damage (HMOD)
1.9.1. How high would you prioritise recommendations to assess for HMOD in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
31.
1.9.2. How feasible would it be to implement recommendations to assess for HMOD in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
32.
1.9.3. Any comments?
4 lines
33.

1.10. Referral to secondary care
1.10.1. How high would you prioritise recommendations to appropriately refer patients to specialist clinics in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
34.
1.10.2. How feasible would it be to implement recommendations to appropriately refer patients to specialist clinics in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
35.
1.10.3. Any comments?
4 lines
36.

2. Chronic Coronary Disease
2.1. Screening for chronic coronary disease in eligible patients 
2.1.1. How high would you prioritise  screening for chronic coronary disease?

Calculating the cardiovascular risk

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

37.

2.1.1. How high would you prioritise  screening for chronic coronary disease?

Selective testing

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

38.

2.1.1. How high would you prioritise  screening for chronic coronary disease?

Opportunistic screening

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

39.

2.1.2. How feasible would it be to implement this recommendation in your clinical setting? 

Calculating the cardiovascular risk

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

40.

2.1.2. How feasible would it be to implement this recommendation in your clinical setting? 

Selective testing

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

41.

2.1.2. How feasible would it be to implement this recommendation in your clinical setting? 

Opportunistic screening

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

42.
2.1.3. Do you have any comments?
4 lines
43.

2.2. Diagnosis of chronic coronary disease using diagnostic criteria
2.2.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of diagnosing chronic coronary disease in your clinical setting?  

Clinical history taking

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

44.

2.2.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of diagnosing chronic coronary disease in your clinical setting?  

Physical examination

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

45.

2.2.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of diagnosing chronic coronary disease in your clinical setting?  

Perform ECG

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

46.

2.2.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of diagnosing chronic coronary disease in your clinical setting?  

Biochemical markers (Trop I)

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

47.

2.2.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of diagnosing chronic coronary disease in your clinical setting?  

Other investigations eg. FBC

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

48.

2.2.2. How feasible would it be to implement the recommendation to improve the diagnosis of chronic coronary disease in your clinical setting?  

Clinical history taking

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

49.

2.2.2. How feasible would it be to implement the recommendation to improve the diagnosis of chronic coronary disease in your clinical setting?  

Physical examination

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

50.

2.2.2. How feasible would it be to implement the recommendation to improve the diagnosis of chronic coronary disease in your clinical setting?  

Perform ECG

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

51.

2.2.2. How feasible would it be to implement the recommendation to improve the diagnosis of chronic coronary disease in your clinical setting?  

Biochemical markers (Trop I)

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

52.

2.2.2. How feasible would it be to implement the recommendation to improve the diagnosis of chronic coronary disease in your clinical setting?  

Other investigations eg. FBC

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

53.
2.2.3. Do you have any comments?
4 lines
54.

2.3. Prepare an appropriate individualized treatment target 
2.3.1. How high would you prioritise improving the implementation of the recommendation to achieve individualised treatment targets in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
55.
2.3.2. How feasible would it be to implement the recommendation to achieve individualised treatment targets in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
56.
2.3.3. Do you have any comments?
4 lines
57.

2.4. Provide Education regarding lifestyle modification
2.4.1. How high would you prioritise improving the implementation of the recommendation to provide education on lifestyle modifications to influence chronic coronary disease management in your clinical setting?

a)
1 Very high priority
b)
2
c)
3
d)
4
e)
5 Very low priority
58.
2.4.2. How feasible would it be to implement the recommendation to provide education on lifestyle modifications to influence chronic coronary disease management in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
59.
2.4.3. Do you have any comments?
4 lines
60.

2.5. Prescribing in chronic coronary disease
2.5.1. How high would you prioritise improving the implementation of the recommendation for prescribing in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
61.
2.5.2. How feasible would it be to implement the recommendation for prescribing in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
62.
2.5.3. Do you have any comments?
4 lines
63.

2.6. Appropriate follow up after initial assessment
2.6.1. How high would you prioritise improving the implementation of the recommendation to schedule appropriate follow-up for chronic coronary disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
64.
2.6.2. How feasible would it be to implement the recommendation to schedule appropriate follow-up for patients with chronic coronary disease in your clinical setting?
a)
1 Not feasible a at all
b)
2
c)
3
d)
4
e)
5 Very feasible
65.
2.6.3. Do you have any comments?
4 lines
66.

2.7. Assessment of complications
2.7.1. How high would you prioritise improving the implementation of the recommendation to assess the complications of chronic coronary disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
67.
2.7.2. How feasible would it be to implement the recommendation to assess the complications of chronic coronary disease in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
68.
2.7.3. Do you have any comments?
4 lines
69.

2.8. Appropriate onward referral to secondary care
2.8.1. How high would you prioritise improving the implementation of the recommendation to refer patients to secondary care in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
70.
2.8.2. How feasible would it be to implement the recommendation to refer patients to secondary care in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
Very feasible
71.
2.8.3. Do you have any comments?
4 lines
72.

3. Chronic Kidney Disease (CKD)
3.1. Screening for chronic kidney disease in eligible patients 

3.1.1. How high would you prioritise improving the implementation of the recommendation to enhance the coverage of screening for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Diabetes

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
73.

3.1.1. How high would you prioritise improving the implementation of the recommendation to enhance the coverage of screening for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Hypertension

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
74.

3.1.1. How high would you prioritise improving the implementation of the recommendation to enhance the coverage of screening for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Cardiovascular disease

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
75.

3.1.2. How feasible would it be to implement the recommendation to screen for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Diabetes

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

76.

3.1.2. How feasible would it be to implement the recommendation to screen for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Hypertension

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

77.

3.1.2. How feasible would it be to implement the recommendation to screen for chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Cardiovascular disease

a)

1 Not at all feasible

b)
2
c)
3
d)
4
e)

5 Very feasible

78.
3.1.3. Do you have any comments?
4 lines
79.

3.2. Frequency of screening for Chronic Kidney Disease

3.2.1. How high would you prioritise improving the implementation of the recommendation for the screening frequency of chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Diabetes

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

80.

3.2.1. How high would you prioritise improving the implementation of the recommendation for the screening frequency of chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Hypertension

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

81.

3.2.1. How high would you prioritise improving the implementation of the recommendation for the screening frequency of chronic kidney disease in patients with the following long-term conditions in your clinical setting?  

Cardiovascular disease

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

82.

3.2.2. How feasible would it be to implement the recommendation for screening for chronic kidney disease in patients with the following conditions in your clinical setting?  

Diabetes

a)

1 Not feasible at all

b)
2
c)
3
d)
4
e)

5 Very feasible

83.

3.2.2. How feasible would it be to implement the recommendation for screening for chronic kidney disease in patients with the following conditions in your clinical setting?  

Hypertension

a)

1 Not feasible at all

b)
2
c)
3
d)
4
e)

5 Very feasible

84.

3.2.2. How feasible would it be to implement the recommendation for screening for chronic kidney disease in patients with the following conditions in your clinical setting?  

Cardiovascular disease

a)

1 Not feasible at all

b)
2
c)
3
d)
4
e)

5 Very feasible

85.
3.2.3. Any Comments
4 lines
86.

3.3. Diagnosis of chronic kidney disease
3.3.1. How high would you prioritise improving the implementation of the recommendation to perform the above tests to diagnose chronic kidney disease in your clinical setting?  

Serum Estimated glomerular filtration rate

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

87.

3.3.1. How high would you prioritise improving the implementation of the recommendation to perform the above tests to diagnose chronic kidney disease in your clinical setting?  

Urine albumin creatinine ratio

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

88.

3.3.2. How feasible would it be to implement the recommendation to perform the above tests to diagnose chronic kidney disease in your clinical setting?   

Serum Estimated glomerular filtration rate

a)

1 Very low priority

b)
2
c)
3
d)
4
e)

5 Very high priority

89.

3.3.2. How feasible would it be to implement the recommendation to perform the above tests to diagnose chronic kidney disease in your clinical setting?   

Urine albumin creatinine ratio

a)

1 Very low feasibility

b)
2
c)
3
d)
4
e)

5 Very high feasibility

90.
3.3.3. Any Comments
4 lines
91.

3.4. Classification of CKD
3.4.1. How high would you prioritise improving the implementation of the recommendation to enhance the process of classification of chronic kidney disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
92.
3.4.2. How feasible would it be to implement the recommendation for the classification of chronic kidney disease in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
93.
3.4.3. Do you have any comments?
4 lines
94.

3.5. Provide Education regarding lifestyle modification
3.5.1. How high would you prioritise improving the implementation of the recommendation to provide education on chronic kidney disease management for patients in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
95.
3.5.2. How feasible would it be to implement the recommendation to provide education on chronic kidney disease management for patients in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
96.
3.5.3. Do you have any comments?
4 lines
97.

3.6. Prescribing for chronic kidney disease
3.6.1. How high would you prioritise improving the implementation of the recommendation to facilitate prescribing decisions for the management of chronic kidney disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
98.
3.6.2. How feasible would it be to implement the recommendation to facilitate prescribing decisions for the management of chronic kidney disease in your clinical setting?
a)
1 Not at all feasible
b)
2
c)
3
d)
4
e)
5 Very feasible
99.
3.6.3. Do you have any comments?
4 lines
100.

3.7. Follow up after initial assessment
3.7.1. How high would you prioritise improving the implementation of the recommendation to schedule appropriate follow-up in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
101.
3.7.2. How feasible would it be to implement the recommendation to schedule appropriate follow-up in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
102.
3.7.3. Do you have any comments?
4 lines
103.

3.8. Assessment of complications of chronic kidney disease
3.8.1. How high would you prioritise improving the implementation of the recommendation to assess and manage anaemia in patients with chronic kidney disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
104.
3.8.2. How feasible is it to implement recommendations to assess and manage anaemia in a patient with chronic kidney disease in your setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
105.
3.8.3. Do you have any other comments?
4 lines
106.

3.9. Complications of CKD - Other
3.9.1. How high would you prioritise improving the implementation of the recommendation to assess other complications in chronic kidney disease in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
107.
3.9.2. How feasible would it be to implement the recommendation to assess other complications in chronic kidney disease in your clinical setting?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
5 Very feasible
108.
3.9.3. Do you have any other comments?
4 lines
109.

3.10. Appropriate referral to secondary care
3.10.1. How high would you prioritise improving the implementation of the recommendation to refer patients to specialist clinics in your clinical setting?

a)
1 Very low priority
b)
2
c)
3
d)
4
e)
5 Very high priority
110.
3.10.2. How feasible would it be to implement the recommendations to refer patients to specialist clinics in your clinical setting ?
a)
1 Not feasible at all
b)
2
c)
3
d)
4
e)
Very feasible
111.
3.10.3. Do you have any comments?
4 lines

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