Improving Care for Patients With Chronic Kidney Disease Using Electronic Medical Record Interventions: A Pragmatic Cluster Randomized Trial
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 221
- Primary Endpoint
- Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
Study Overview
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 Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Sex
- All
- Accepts Healthy Volunteers
- Yes
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
Arms & Interventions
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
Intervention: CKD feedback and tools (Behavioral)
No Intervention
Physicians in these clinics/clusters will not receive CKD feedback or tools
Outcomes
Primary Outcomes
Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
Time Frame: 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 Outcomes
- Proportion of patients with an initial eGFR <60 and a f/u eGFR or an ACR(24 months)
- Proportion of patients meeting eGFR criteria for CKD and documentation of CKD in the cumulative patient profile (CPP)(24 months)
- Proportion of patients age less than 80 years and an eGFR<30 being seen by or with a referral to a Nephrologist(24 months)
- Proportion of patients at high risk screened for CKD with an eGFR and/or ACR(24 months)
- Proportion of patients with diabetes and albuminuria and on an ACE or ARB(24 months)
- Proportion of patients with an ACR in the past 18 months and meeting bp targets(24 months)
Investigators
Dr. Karen Tu
Senior Scientist
Sunnybrook Health Sciences Centre