Evaluation of an Electronic CKD Clinical Decision Support System (CDSS) in Clinical Care

Completed · Not applicable

Conditions studied: Hypertension, Renal Insufficiency, Chronic

In brief

The investigators propose a three-arm, pragmatic, cluster-randomized clinical trial based in primary care. Participating Primary Care Providers (PCPs) will be randomized to usual care or one of two intervention arms. The first intervention will evaluate the efficacy of an automated CDSS that utilizes the electronic health record (EHR) to facilitate triple marker test ordering, guideline implementation and BP management, compared with usual care, among patients with previous documentation of eGFRcreat \<60 ml/min/1.73m2. The second intervention goes a step further, and will evaluate whether a CDSS plus a follow-up telephone call from a pharmacist (CDSS PLUS) can improve BP management and patient CKD and NSAID toxicity knowledge among the patients with CKD, compared with CDSS alone. The primary clinical outcome is BP level, with secondary outcomes related to processes of care and patient knowledge.

Key facts

Study ID

NCT02925962

Run by

University of California, San Francisco

People needed

542

Starts

2017-08-14

Expected to finish

2020-06-30

Last updated by the study team

2020-08-12

Who can join

Age: 18 and older, up to 80. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Have at least two outpatient, documented eGFRcreat values 30- 59 ml/min/1.72m2 that are at least ≥3 months apart
• At least one of these measurements should be within 12 months.
• Patients have seen their primary care physician at least one time within the previous 18 months
• Patient's primary care providers agree to participate

You may not qualify if…

• Patients actively and recently seen by nephrology clinic (at least once in the past 12 months)
• Patients with a diagnosis of end stage renal disease
• Persons aged >80
• Persons with New York Heart Association (NYHA) class III or IV heart failure, known ejection fraction < 25%, or documented allergy to ace/arb.
• Patients on dialysis, kidney transplant recipients and pregnant women
• Patients with prevalent dementia, impaired cognition or severe mental illness; expected life expectancy < 6 months.
• There will also be a category where the physician can opt out for specific patients in their panel due to not believing this person should be included in the study for any reason.

Where it is running

• UCSF Division of General Internal Medicine — San Francisco, California, United States

Full record on ClinicalTrials.gov

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