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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00688285
Recruitment Status : Completed
First Posted : June 2, 2008
Last Update Posted : March 25, 2011
Information provided by:
University of Pittsburgh

Brief Summary:
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 or disease Intervention/treatment Phase
Chronic Kidney Disease Other: automated clinical alerts Other: provider education Not Applicable

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.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 248 participants
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
Study Start Date : December 2008
Actual Primary Completion Date : December 2009
Actual Study Completion Date : December 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Kidney Diseases

Arm Intervention/treatment
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

Primary Outcome Measures :
  1. referral to a nephrologist [ Time Frame: 12 months ]
    Referral to a nephrologist within the 12 months following decision support system activation.

Secondary Outcome Measures :
  1. 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.

  2. Annual ACR or PCR check [ Time Frame: 12 months ]
    ACR or PCR within 12months of the decision support system activation

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

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.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00688285

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

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Khaled Abdel-Kader, University of Pittsburgh Identifier: NCT00688285    
Other Study ID Numbers: PRO07110299
First Posted: June 2, 2008    Key Record Dates
Last Update Posted: March 25, 2011
Last Verified: March 2011
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:
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Kidney Diseases
Renal Insufficiency, Chronic
Urologic Diseases
Renal Insufficiency