Automated Clinical Reminders in the Care of Chronic Kidney Disease Patients (ACRinCKD)
|Chronic Kidney Disease||Other: automated clinical alerts Other: provider education|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||Automated Clinical Reminders in the Care of Chronic Kidney Disease Patients|
- referral to a nephrologist [ Time Frame: 12 months ]Referral to a nephrologist within the 12 months following decision support system activation.
- Use of ACE/ARB [ Time Frame: 12 months ]Active use of ACE/ARB at the end of the 12 month period following decision support system activation.
- Annual ACR or PCR check [ Time Frame: 12 months ]ACR or PCR within 12months of the decision support system activation
|Study Start Date:||December 2008|
|Study Completion Date:||December 2009|
|Primary Completion Date:||December 2009 (Final data collection date for primary outcome measure)|
Active Comparator: 1
education and automated clinical alerts
Other: automated clinical alerts
automated clinical alerts in the electronic medical recordOther: provider education
PCP education session on CKD
Active Comparator: 2
education session alone
Other: provider education
PCP education session on CKD
Literature supports that most chronic kidney disease (CKD) patients are cared for by primary care physicians (PCP) without the help of a kidney specialist. Many of these patients fail to achieve targeted outcomes and late referral to a nephrologist has been associated with an increased risk of death. Automated computerized clinical reminders have been shown to improve physician compliance with recommended guidelines in other settings.
Aims: To determine if clinical reminders can help PCPs decrease the rate of late referrals, improve urine albumin checks in CKD patients
Design: prospective randomized controlled, single-blinded study with additional historical control
Methods: Two 20-minute teaching sessions aimed at all GIM PCPs in the UPMC clinic followed by randomization of the eligible GIM providers to receive automated clinical reminders (CR) for their CKD stage 3b-5 patients versus routine care.
Outcomes: Using a database search, individuals with an eGFR<45ml/min/1.73m2 (not seen by a nephrologist) will have data collected on: PCP referral to a nephrologist, urinary albumin (or protein) quantification in the past year, PCP recognition of patients with eGFR<45ml/min, ACE/ARB usage.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00688285
|United States, Pennsylvania|
|University of Pittsburgh|
|Pittsburgh, Pennsylvania, United States, 15261|
|Principal Investigator:||Khaled Abdel-Kader, MD||University of Pittsburgh|
|Principal Investigator:||Mark Unruh, MD, MSc||University of Pittsburgh|