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Multifaceted Intervention to Improve Prescribing in Patients With Chronic Kidney Disease

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified March 2007 by McMaster University.
Recruitment status was:  Not yet recruiting
National Research System-College of Family Physicians of Canada
Information provided by:
McMaster University Identifier:
First received: March 9, 2007
Last updated: NA
Last verified: March 2007
History: No changes posted

In 2001, an estimated 1.9 million Canadians had chronic renal disease and the number of patients being treated for end stage renal disease climbed by nearly 20% in 5 years. Many medications commonly used in elderly patients are excreted by the kidney. Failure to adjust doses in those with impaired renal function can result in medication overdose, leading to potentially serious morbidity and mortality. Studies in hospitals and long term care facilities have found a 19-67% rate of non-compliance with guidelines for medication dose adjustment in patients with renal insufficiency and in ambulatory care one study found a 69% rate of non-compliance. Since primary care physicians write 80% of prescriptions for those aged 65 years, there is a need for interventions to improve prescribing to patients with renal impairment in primary care.

This study will develop an audit tool and electronic decision support tool that will be incorporated into the electronic medical record in a large academic family health centre. It is seen as a preliminary step in a project to assess the effectiveness of a multifaceted intervention including chart audit, personalized feedback to prescribers, a pharmacist-facilitated group learning session and the use of an electronic decision support tool incorporated into the electronic medical record.

Condition Intervention
Chronic Kidney Disease Behavioral: computer decision support tool Behavioral: audit and feedback Behavioral: group learning session

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Health Services Research
Official Title: Multifaceted Intervention to Improve Prescribing of Medications Requiring Dose Adjustment in Patients With Chronic Kidney Disease

Resource links provided by NLM:

Further study details as provided by McMaster University:

Primary Outcome Measures:
  • The primary outcome will be a change in the number of appropriately written prescriptions for the targeted medications 3 and 6 months after the educational intervention and introduction of the clinical decision support tool.

Secondary Outcome Measures:
  • Prescribers’ perception of their knowledge of and comfort with adjusting doses of medications as measured in a Likert scale and their assessement of the ease of use of the decision support tool
  • , cost savings, time for prescribers to use the decision support tool, number of times the decision support tool was used.

Study Start Date: March 2007
Estimated Study Completion Date: March 2007
  Show Detailed Description


Ages Eligible for Study:   65 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients 65 years or older who have been prescribed one or more of the targeted medications and who have a creatinine from within the previous year on record will be included.

Exclusion Criteria:

  • Patients on dialysis
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00446615

Contact: Imaan Bayoumi, MD 905 575-1300
Contact: Lisa McCarthy 905 575-1300

Canada, Ontario
Stonechurch Family Health Centre Not yet recruiting
Hamilton, Ontario, Canada, L8W 3J6
Contact: Imaan Bayoumi    905 575-1300   
Contact: Lisa McCarthy    905 575-1300   
Principal Investigator: Imaan Bayoumi         
Principal Investigator: Lisa McCarthy         
Sub-Investigator: David Chan         
Sponsors and Collaborators
Hamilton Health Sciences Corporation
National Research System-College of Family Physicians of Canada
Principal Investigator: Imaan Bayoumi McMaster University
Principal Investigator: Lisa McCarthy McMaster University
  More Information Identifier: NCT00446615     History of Changes
Other Study ID Numbers: CR-168
Study First Received: March 9, 2007
Last Updated: March 9, 2007

Keywords provided by McMaster University:
computer decision support
primary care
kidney disease, chronic

Additional relevant MeSH terms:
Kidney Diseases
Renal Insufficiency, Chronic
Urologic Diseases
Renal Insufficiency processed this record on September 21, 2017