Improving Care for Patients With Chronic Kidney Disease Using Electronic Medical Record Interventions: A Pragmatic Cluster Randomized Trial
试验速览
- 阶段
- 不适用
- 入组人数
- 221
- 主要终点
- Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •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
排除标准
- •Updated data available at the time of study commencement
研究组 & 干预措施
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
干预措施: CKD feedback and tools (Behavioral)
No Intervention
Physicians in these clinics/clusters will not receive CKD feedback or tools
结局指标
主要结局
Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
时间窗: 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
次要结局
- 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)
研究者
Dr. Karen Tu
Senior Scientist
Sunnybrook Health Sciences Centre