Improving Care for Patients With Chronic Kidney Disease Using EMRALD

Not Applicable

• Conditions: Chronic Kidney Disease
• Interventions: Behavioral: CKD feedback and tools

• Registration Number: NCT02274298
• Lead Sponsor: Sunnybrook Health Sciences Centre

Brief Summary

This pragmatic cluster randomized controlled trial will test the impact of feedback and a toolkit aimed at improving the management of chronic kidney disease (CKD) in the primary care setting. This trial will use family physicians in Ontario participating in the Electronic.

Detailed Description

This trial will use family physicians in Ontario participating in the Electronic Medical Record Administrative data Linked Database (EMRALD) and receiving the System for Audit and Feedback to Improve caRE (SAFIRE) along with other decision support tools. Performance on CKD quality indicators for family physicians receiving the CKD feedback and tools will be compared to physicians not receiving the CKD feedback or tools.

Study Timeline

• Study Start: 2014-10
• Study First Submitted: 2014-10-06
• Study First Submitted QC: 2014-10-23
• Study First Posted: 2014-10-24
• Status Verified: 2016-10
• Last Update Submitted: 2016-10-13
• Last Update Posted: 2016-10-14
• Primary Completion: 2017-04
• Study Completion: 2017-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 221

Inclusion Criteria

• Family physicians participating in EMRALD, on the EMR for >=2 years, roster size >=100 patients
• Patient criteria, rostered and actively seeing an EMRALD physician, on the EMR for .=1 year

Exclusion Criteria

• Updated data available at the time of study commencement

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
CKD feedback and tools	CKD feedback and tools	Physicians in these clinics/clusters will receive feedback on their performance for screening and managing CKD quality indicators as well as EMR tools to aid in their performance

Primary Outcome Measures

Name	Time	Method
Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription	24 months	Comparison of proportion of patients age 50-80 years with Stage 3+ CKD (no dialysis or renal transplant) and receiving a statin prescription at baseline and at the end of the trial

Secondary Outcome Measures

Name	Time	Method
Proportion of patients with an initial eGFR <60 and a f/u eGFR or an ACR	24 months	compare baseline rates to end of intervention rates
Proportion of patients meeting eGFR criteria for CKD and documentation of CKD in the cumulative patient profile (CPP)	24 months	compare baseline rates to end of intervention rates
Proportion of patients age less than 80 years and an eGFR<30 being seen by or with a referral to a Nephrologist	24 months	compare baseline rates to end of intervention rates
Proportion of patients at high risk screened for CKD with an eGFR and/or ACR	24 months	compare baseline rates to end of intervention rates
Proportion of patients with diabetes and albuminuria and on an ACE or ARB	24 months	compare baseline rates to end of intervention rates
Proportion of patients with an ACR in the past 18 months and meeting bp targets	24 months	compare baseline rates to end of intervention rates