Open AccessEffect of 2 Clinical Decision Support Strategies on Chronic Kidney Disease Outcomes in Primary Care
Author(s) -
Jennifer K. Carroll,
Gerald Pulver,
L. Miriam Dickinson,
Wilson Pace,
Joseph A. Vassalotti,
Kim S. Kimminau,
Brian Manning,
Elizabeth W. Staton,
Chester H. Fox
Publication year - 2018
Publication title -
jama network open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.278
H-Index - 39
ISSN - 2574-3805
DOI - 10.1001/jamanetworkopen.2018.3377
Subject(s) - primary care , intensive care medicine , medicine , kidney disease , disease , clinical decision support system , decision support system , family medicine , computer science , artificial intelligence
Key Points Question Can clinical decision support plus practice facilitation improve treatment of chronic kidney disease (CKD) in primary care, with the goal of delaying progression of CKD from stages 3 and 4? Findings This cluster randomized clinical trial of 30 primary care practices comprising 6699 patients showed a significant effect in the intervention group compared with the control group in slowing the annualized loss of estimated glomerular filtration rate in patients with stages 3 and 4 CKD. There was significant improvement in hemoglobin A 1c over time among patients in the intervention group compared with patients in the control group, with an imbalance between groups resulting from practice dropout posing a significant limitation. Meaning Findings suggest that a multimodal intervention in primary care can slow the progression of stages 3 and 4 CKD.
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