Early Identification and Action in CKD

Geisinger Health

Status: Completed

Conditions: Chronic Kidney Disease; Hypertension

Treatments: Other: Protocolized, pharmacist-delivered CKD Action Plan

Study type: Interventional

Funder types: Other

Identifiers

NCT02208674

2014-0251

Details and patient eligibility

About

Chronic kidney disease (CKD) is highly prevalent and associated with significantly increased risk of cardiovascular morbidity and end-stage renal disease. Evidence from randomized clinical trials suggests that treating urinary albumin excretion (UAE), dyslipidemia, and hypertension will reduce these risks. Unfortunately, less than 30% of the CKD population is screened and treated according to recommended guidelines. Using a cluster-randomized, controlled design and clinic-embedded pharmacists, this pilot pragmatic trial will randomize 6 Geisinger primary care clinics (72 patients) to usual care (group 1) or a pharmacist-directed "CKD Action Plan" (group 2). Determining the impact of the CKD Action Plan on screening and treatment guideline adherence is the primary goal of this pilot study.

Enrollment: 47 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years of age or older
• eGFRCR value between 45-59 ml/min/1.73m2 in the prior 12 months
• scheduled laboratory appointment for serum creatinine testing within the next 30 days
• average systolic or diastolic blood pressure reading of at least 150 or 85 mm Hg, respectively, during the prior 12 months.

Exclusion criteria

• fewer than 2 blood pressure readings in the prior 12 months,
• pregnancy
• current hospitalization
• life expectancy less than 6 months as determined by the study investigators

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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47 participants in 2 patient groups

Usual Care

No Intervention group

Description:

Primary care provider-delivered screening and treatment for risk factors (hypertension, albuminuria, dyslipidemia) per usual care.

Protocolized, pharmacist-delivered CKD Action Plan

Experimental group

Description:

Protocolized, pharmacist-delivered screening and treatment for risk factors (hypertension, albuminuria, dyslipidemia) per KDIGO and JNC-8 recommendations.

Treatment:

Other: Protocolized, pharmacist-delivered CKD Action Plan