An interventional study of CKD Registry in Hypertension and Chronic Kidney Diseases, sponsored by University of California, San Francisco. Completed. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-03-22.
Sponsored by University of California, San Francisco · Not applicable, Interventional, and Treatment
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.
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.
Exclusion Criteria:
PCPs who solely provided specialty care, for example HIV services or urgent care, were excluded.
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.
Other: CKD 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.
Health Service intervention
Change in clinic systolic
Change in ambulatory systolic BP measured at ambulatory clinic visits in the health care system.
Time frame: 12 months
Change in proportion of patients with BP control
Change in the proportion of patients with BP control defined by BP \<140/\<90 mmHg at an ambulatory clinic visit.
Time frame: 12 months
Change in proportion fo patients with urine albuminuria quantification
Change in proportion of patients whose albuminuria was quantified by a urine test among those had not received quantification at trial initiation.
Time frame: 12 months
Change in albuminuria severity
Change in albuminuria severity (mg urine albumin/g urine creatinine) among those patients with albuminuria quantified at trial initiation
Time frame: 12 months
Change in proportion of patients with ACEi/ARB prescription
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)
Time frame: 12 months
No study locations are listed for this record.
Plan to share: No — data can be shared when requested by other individual researchers
No publications or documents are linked to this record.
This study is completed, as verified in Mar 2018. You cannot join it, but the record below documents what was studied.
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University of California, San Francisco