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Automated Clinical Reminders in the Care of Chronic Kidney Disease Patients (ACRinCKD)

This study has been completed.
Sponsor:
Information provided by:
University of Pittsburgh
ClinicalTrials.gov Identifier:
NCT00688285
First received: May 28, 2008
Last updated: March 24, 2011
Last verified: March 2011
History of Changes
  Purpose

To determine whether the use of educational sessions and computerized clinical reminders can improve primary care doctors' delivery of care to CKD patients compared to educational sessions alone. Hypothesis: Clinical reminders will improve the care delivered to CKD patients


Condition Intervention
Chronic Kidney Disease
 Other: automated clinical alerts
Other: provider education

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Automated Clinical Reminders in the Care of Chronic Kidney Disease Patients

Resource links provided by NLM:

U.S. FDA Resources

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • referral to a nephrologist [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    Referral to a nephrologist within the 12 months following decision support system activation.


Secondary Outcome Measures:
  • Use of ACE/ARB [ Time Frame: 12 months ] [ Designated as safety issue: No ]
    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 ] [ Designated as safety issue: No ]
    ACR or PCR within 12months of the decision support system activation


Enrollment: 248
Study Start Date: December 2008
Study Completion Date: December 2009
Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
education and automated clinical alerts
 Other: automated clinical alerts
automated clinical alerts in the electronic medical record
Other: provider education
PCP education session on CKD
Active Comparator: 2
education session alone
 Other: provider education
PCP education session on CKD

Detailed Description:

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.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • For PCPs: all GIM attending physicians with a weekly continuity clinic.
  • For patients: >= 18 years-old with an eGFR<45ml/min/1.73m2 being seen in the UPMC GIM clinic by a faculty member during the 10-month intervention period

Exclusion Criteria:

  • for PCPs: imminent plans to leave the department
  • patients with a renal transplant, on any form of dialysis, or with a previous nephrology evaluation.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00688285

Locations
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15261
Sponsors and Collaborators
University of Pittsburgh
Investigators
Principal Investigator: Khaled Abdel-Kader, MD University of Pittsburgh
Principal Investigator: Mark Unruh, MD, MSc University of Pittsburgh
  More Information

No publications provided by University of Pittsburgh

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Responsible Party: Khaled Abdel-Kader, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00688285     History of Changes
Other Study ID Numbers: PRO07110299
Study First Received: May 28, 2008
Last Updated: March 24, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by University of Pittsburgh:
chronic kidney disease
clinical alerts
late referral
electronic medical record
Computerized clinical decision support systems (CDSS)

Additional relevant MeSH terms:
Kidney Diseases
Renal Insufficiency, Chronic
Kidney Failure, Chronic
Urologic Diseases
Renal Insufficiency

ClinicalTrials.gov processed this record on May 23, 2013