Chronic Kidney Disease
Conditions
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.
Interventions
BEHAVIORALCKD feedback and tools
people in the intervention arm will receive feedback on ckd quality indicators and tools to help in the detection and management of ckd
Sponsors
Ontario Renal Network
Sunnybrook Health Sciences Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription | 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
| Measure | Time frame | Description |
|---|---|---|
| Proportion of patients with an initial eGFR <60 and a f/u eGFR or an ACR | 24 months | compare baseline rates to end of intervention rates |
| Proportion of patients with diabetes and albuminuria and on an ACE or ARB | 24 months | compare baseline rates to end of intervention rates |
| Proportion of patients at high risk screened for CKD with an eGFR and/or ACR | 24 months | compare baseline rates to end of intervention rates |
| Proportion of patients with an ACR in the past 18 months and meeting bp targets | 24 months | compare baseline rates to end of intervention rates |
| Proportion of patients age less than 80 years and an eGFR<30 being seen by or with a referral to a Nephrologist | 24 months | compare baseline rates to end of intervention rates |
| Proportion of patients meeting eGFR criteria for CKD and documentation of CKD in the cumulative patient profile (CPP) | 24 months | compare baseline rates to end of intervention rates |
Outcome results
None listed