Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2011
Automated clinical reminders for primary care providers in the care of CKD: a small cluster-randomized controlled trial.
Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 11 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- Pooled it
- Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary health care.The Cochrane database of systematic reviews · 2025Pooled it
- Electronic Health Record Nudges and Health Care Quality and Outcomes in Primary Care: A Systematic Review.JAMA network open · 2024Pooled it
- Interventions for improving health literacy in people with chronic kidney disease.The Cochrane database of systematic reviews · 2022Pooled it
- Design, effectiveness, and economic outcomes of contemporary chronic disease clinical decision support systems: a systematic review and meta-analysis.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Improving Blood Pressure Management in Primary Care Patients with Chronic Kidney Disease: a Systematic Review of Interventions and Implementation Strategies.Journal of general internal medicine · 2020Pooled it
- Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials.BMJ (Clinical research ed.) · 2020Pooled it
- eHealth interventions for people with chronic kidney disease.The Cochrane database of systematic reviews · 2019Pooled it
- Chronic disease management interventions for people with chronic kidney disease in primary care: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Pooled it
- Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis.American journal of public health · 2014Pooled it
- The effects of on-screen, point of care computer reminders on processes and outcomes of care.The Cochrane database of systematic reviews · 2009Pooled it
- User Actions within a Clinical Decision Support Alert for the Management of Hypertension in Chronic Kidney Disease.Applied clinical informatics · 2025Trial
- Impact of a Primary Care CKD Registry in a US Public Safety-Net Health Care Delivery System: A Pragmatic Randomized Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2018Trial
- A pharmacist based intervention to improve the care of patients with CKD: a pragmatic, randomized, controlled trial.BMC nephrology · 2015Trial
- Impact of a chronic kidney disease registry and provider education on guideline adherence--a cluster randomized controlled trial.BMC medical informatics and decision making · 2012Trial
- Care Processes and Clinical Responses to Newly Detected Albuminuria: The Stockholm Creatinine Measurements (SCREAM) Project.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Improving CKD Screening and Care in Diabetes Using Clinical Decision Support in a Large Health Care System.Kidney360 · 2025Article
- Identifying and Characterising a Chronic Kidney Disease Electronic-Phenotype Using Electronic Health Record-Derived Data: A Narrative Review of Strategies and Applications.Nephrology (Carlton, Vic.) · 2025Review
- Population Health Management for Improving Kidney Health Outcomes.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025Article
- Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundPrimary care physicians (PCPs) care for most non-dialysis-dependent patients with chronic kidney disease (CKD). Studies suggest that PCPs may deliver suboptimal CKD care. One means to improve PCP treatment of CKD is clinical decision support systems (CDSSs). STUDY
designCluster-randomized controlled trial. SETTING &
participants30 PCPs in a university-based outpatient general internal medicine practice and their 248 patients with moderate to advanced CKD who had not been referred to a nephrologist.
intervention2 CKD educational sessions were held for PCPs in both arms. The 15 intervention-arm PCPs also received real-time automated electronic medical record alerts for patients with estimated glomerular filtration rates <45 mL/min/1.73 m(2) recommending renal referral and urine albumin quantification if not done within the prior year. OUTCOMES: Primary outcome was referral to a nephrologist; secondary outcomes were albuminuria/proteinuria assessment, CKD documentation, optimal blood pressure (ie, <130/80 mm Hg), and use of renoprotective medications.
resultsThe intervention and control arms did not differ in renal referrals (9.7% vs 16.5%, respectively; between-group difference, -6.8%; 95% CI, -15.5% to 1.8%; P = 0.1) or proteinuria assessments (39.3% vs 30.1%, respectively; between-group difference, 9.2%; 95% CI, -2.7% to 21.1%; P = 0.1). For intervention and control patients without a baseline proteinuria assessment, 27.7% versus 16.3%, respectively, had one at follow-up (P = 0.06). After controlling for clustering, these findings were largely unchanged and no significant differences were apparent between groups. LIMITATIONS: Small single-center university-based practice, use of a passive CDSS that required PCPs to trigger the electronic order set.
conclusionsPCPs were willing to partake in a randomized trial of a CDSS to improve outpatient CKD care. Although CDSSs may have potential, larger studies are needed to further explore how best to deploy them to enhance CKD care.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.