Chronic Kidney Disease (CKD) Guideline Adherence - A Quality Improvement Study

Not Applicable

Completed

• Conditions: Chronic Renal Insufficiency
• Interventions: Behavioral: Multifactorial intervention; Behavioral: Education only

• Registration Number: NCT00921687
• Lead Sponsor: Louis Stokes VA Medical Center

Brief Summary

Chronic kidney disease (CKD) is defined as kidney damage for greater than 3 months or a glomerular filtration rate less than 60 mL/min per 1.73m2 for greater than 3 months. Patients with CKD are at high risk for development of cardiovascular disease and metabolic complications. Guidelines for the care of patients with CKD have been developed by the National Kidney Foundation. Despite the wide availability of these guidelines, adherence is low. The goal of the current study is to evaluate whether a multifactorial intervention, including a CKD registry, will improve CKD guideline adherence. The hypothesis is that providers exposed to a multifactorial clinical intervention including education, academic detailing, and a CKD registry will be more likely to adhere to CKD guidelines than those only exposed to education.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2009-06-15
• Study First Submitted QC: 2009-06-15
• Study First Posted: 2009-06-16
• Study Start: 2009-07
• Primary Completion: 2010-06
• Study Completion: 2010-06
• Results First Submitted: 2012-07-30
• Results First Submitted QC: 2013-04-16
• Status Verified: 2013-05
• Last Update Submitted: 2013-05-22
• Results First Posted: 2013-05-23
• Last Update Posted: 2013-05-27

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 781

Inclusion Criteria

• All primary care providers at the Wade Park Veterans Affairs Medical Center (VAMC) will be eligible for the study

Patients:

Inclusion Criteria:

• Receive primary care from a provider at the Wade Park VAMC

• Have:

  • CKD as defined by an estimated glomerular filtration rate (eGFR) less than 60 on two separate occasions 90 to 730 days apart,
  • diabetes, OR
  • hypertension

Exclusion Criteria

• End-stage renal disease
• Renal transplant recipients
• Less than 18 years of age on July 1, 2009
• No primary care visit between Jan 1, 2008 and July 1, 2009

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Multifactorial intervention	Multifactorial intervention	The multifactorial intervention will consist of a CKD lecture, the CKD reference card, academic detailing, and access to the CKD registry.
Education only	Education only	Providers in the education only arm will receive a CKD lecture and be given a CKD reference card.

Primary Outcome Measures

Name	Time	Method
PTH (Parathyroid Hormone) Adherence	One year	Probability for having a PTH measured during the study period comparing intervention vs control clinic during the study period as estimated by Generalized Estimating Equation (determines probability, not proportion). Participants assigned 1 if PTH was measured and 0 if PTH was not measured during the study period.

Secondary Outcome Measures

Name	Time	Method
Last Clinic BP <130/80 mmHg	One year	Probability of last Clinic BP \<130/80 mmHg Comparing Intervention vs Control Clinic During the Study Period as estimated using Generalized Estimating Equation.

Trial Locations

Locations (1)

Louis Stokes Cleveland Veterans Affairs Medical Center; 🇺🇸 Cleveland, Ohio, United States