Impact of a Safety-Net Primary Care CKD Registry
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 746
- 主要终点
- Change in clinic systolic
研究概览
简要总结
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •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.
排除标准
- •PCPs who solely provided specialty care, for example HIV services or urgent care, were excluded.
研究组 & 干预措施
Chronic Kidney Disease (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.
干预措施: CKD Registry (Other)
Usual Care Registry
Usual care consisted of an electronic registry that was in use before trial implementation. It provided practice teams with point-of-care data about diabetes care, age-appropriate cancer screening and immunizations, but no CKD-related data. Medical assistants were encouraged to use the usual care registry to identify patients who were due for cancer screening or immunizations. Quarterly feedback was not provided for practice teams randomized to receive usual care.
结局指标
主要结局
Change in clinic systolic
时间窗: 12 months
Change in ambulatory systolic BP measured at ambulatory clinic visits in the health care system.
次要结局
- Change in proportion fo patients with urine albuminuria quantification(12 months)
- Change in proportion of patients with BP control(12 months)
- Change in proportion of patients with ACEi/ARB prescription(12 months)
- Change in albuminuria severity(12 months)