search
Back to results

Improving Care for Patients With Chronic Kidney Disease Using EMRALD

Primary Purpose

Chronic Kidney Disease

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
CKD feedback and tools
Sponsored by
Sunnybrook Health Sciences Centre
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Chronic Kidney Disease

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

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

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    No Intervention

    Arm Label

    CKD feedback and tools

    No Intervention

    Arm Description

    Physicians in these clinics/clusters will receive feedback on their performance for screening and managing CKD quality indicators as well as EMR tools to aid in their performance

    Physicians in these clinics/clusters will not receive CKD feedback or tools

    Outcomes

    Primary Outcome Measures

    Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
    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 Outcome Measures

    Proportion of patients at high risk screened for CKD with an eGFR and/or ACR
    compare baseline rates to end of intervention rates
    Proportion of patients with an initial eGFR <60 and a f/u eGFR or an ACR
    compare baseline rates to end of intervention rates
    Proportion of patients with diabetes and albuminuria and on an ACE or ARB
    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)
    compare baseline rates to end of intervention rates
    Proportion of patients with an ACR in the past 18 months and meeting bp targets
    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
    compare baseline rates to end of intervention rates

    Full Information

    First Posted
    October 6, 2014
    Last Updated
    October 13, 2016
    Sponsor
    Sunnybrook Health Sciences Centre
    Collaborators
    Ontario Renal Network
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT02274298
    Brief Title
    Improving Care for Patients With Chronic Kidney Disease Using EMRALD
    Official Title
    Improving Care for Patients With Chronic Kidney Disease Using Electronic Medical Record Interventions: A Pragmatic Cluster Randomized Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2016
    Overall Recruitment Status
    Unknown status
    Study Start Date
    October 2014 (undefined)
    Primary Completion Date
    April 2017 (Anticipated)
    Study Completion Date
    April 2017 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Sunnybrook Health Sciences Centre
    Collaborators
    Ontario Renal Network

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    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.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Chronic Kidney Disease

    7. Study Design

    Primary Purpose
    Prevention
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    221 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    CKD feedback and tools
    Arm Type
    Active Comparator
    Arm Description
    Physicians in these clinics/clusters will receive feedback on their performance for screening and managing CKD quality indicators as well as EMR tools to aid in their performance
    Arm Title
    No Intervention
    Arm Type
    No Intervention
    Arm Description
    Physicians in these clinics/clusters will not receive CKD feedback or tools
    Intervention Type
    Behavioral
    Intervention Name(s)
    CKD feedback and tools
    Intervention Description
    people in the intervention arm will receive feedback on ckd quality indicators and tools to help in the detection and management of ckd
    Primary Outcome Measure Information:
    Title
    Proportion of patients age 50-80 with Stage 3+ CKD and a statin prescription
    Description
    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
    Time Frame
    24 months
    Secondary Outcome Measure Information:
    Title
    Proportion of patients at high risk screened for CKD with an eGFR and/or ACR
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months
    Title
    Proportion of patients with an initial eGFR <60 and a f/u eGFR or an ACR
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months
    Title
    Proportion of patients with diabetes and albuminuria and on an ACE or ARB
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months
    Title
    Proportion of patients meeting eGFR criteria for CKD and documentation of CKD in the cumulative patient profile (CPP)
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months
    Title
    Proportion of patients with an ACR in the past 18 months and meeting bp targets
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months
    Title
    Proportion of patients age less than 80 years and an eGFR<30 being seen by or with a referral to a Nephrologist
    Description
    compare baseline rates to end of intervention rates
    Time Frame
    24 months

    10. Eligibility

    Sex
    All
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    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
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Karen Tu, MD, MSc
    Organizational Affiliation
    ICES/Sunnybrook
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    No, final results will be aggregate although as part of the trial individual participants do receive individual level feedback
    Citations:
    PubMed Identifier
    28607686
    Citation
    Nash DM, Ivers NM, Young J, Jaakkimainen RL, Garg AX, Tu K. Improving Care for Patients With or at Risk for Chronic Kidney Disease Using Electronic Medical Record Interventions: A Pragmatic Cluster-Randomized Trial Protocol. Can J Kidney Health Dis. 2017 Apr 5;4:2054358117699833. doi: 10.1177/2054358117699833. eCollection 2017.
    Results Reference
    derived

    Learn more about this trial

    Improving Care for Patients With Chronic Kidney Disease Using EMRALD

    We'll reach out to this number within 24 hrs