Primary Care CKD Registry

Not Applicable

Completed

• Conditions: Chronic Kidney Diseases; Hypertension
• Interventions: Other: CKD Registry

• Registration Number: NCT03473509
• Lead Sponsor: University of California, San Francisco

Brief Summary

This study examines whether a safety-net primary care CKD registry directed at the entire primary care team can enhance the delivery of guideline concordant CKD care, including BP control, ACEi/ARB use and albuminuria quantification.

Detailed Description

Not available

Study Timeline

• Study Start: 2013-06
• Primary Completion: 2015-03
• Study Completion: 2015-03
• Status Verified: 2018-03
• Study First Submitted: 2018-03-09
• Study First Submitted QC: 2018-03-20
• Last Update Submitted: 2018-03-20
• Study First Posted: 2018-03-22
• Last Update Posted: 2018-03-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 746

Inclusion Criteria

All PCPs who worked in practice teams and provided longitudinal primary care to patients were eligible to participate in this study. Practice teams that consisted of several physicians (+/- trainees), one nurse, nurse practitioners, medical assistants and behaviorists, were randomized 1:1 to one of two arms with a random number generator: access to an electronic CKD registry or a usual care registry for 12 months.

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Exclusion Criteria

PCPs who solely provided specialty care, for example HIV services or urgent care, were excluded.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Chronic Kidney Disease (CKD) Registry	CKD Registry	The CKD registry provided primary care practice teams with point-of-care data about patient-specific CKD status, recent ambulatory clinic blood pressure (BP) readings, status of Angiotensin Converting Enzyme inhibitor (ACEi) or Angiotensin Receptor Blocker (ARB) prescription, and quantification of albuminuria (UACR). It also provided data about diabetes care, immunization status, and data pertinent to age appropriate cancer screening, to align with usual care. Point-of-care decision support reminded primary care providers (PCPs) about guideline concordant care for individuals with CKD. Quarterly feedback to practice teams and individual PCPs identified patients with CKD and BP \>140/90 mmHg, those not prescribed an ACEi/ARB, and those with albuminuria.

Primary Outcome Measures

Name	Time	Method
Change in clinic systolic	12 months	Change in ambulatory systolic BP measured at ambulatory clinic visits in the health care system.

Secondary Outcome Measures

Name	Time	Method
Change in proportion fo patients with urine albuminuria quantification	12 months	Change in proportion of patients whose albuminuria was quantified by a urine test among those had not received quantification at trial initiation.
Change in proportion of patients with BP control	12 months	Change in the proportion of patients with BP control defined by BP \<140/\<90 mmHg at an ambulatory clinic visit.
Change in proportion of patients with ACEi/ARB prescription	12 months	Change in proportion of patients prescribed an ACEi/ARB in the clinical record or had a documented reason for no prescription (i.e., allergy, prior development of hyperkalemia, or acute kidney injury)
Change in albuminuria severity	12 months	Change in albuminuria severity (mg urine albumin/g urine creatinine) among those patients with albuminuria quantified at trial initiation