Evidence map›Paper›PMID 38182983›Full record

ArticleBMC nephrology2024

Pharmacist-driven outreach initiative to increase prescribing of sodium-glucose cotransporter-2 inhibitors in eligible VHA patients with chronic kidney disease: a study protocol.

Deborah L Pestka, Daniel Murphy, Pearl Huynh, Jessica A Rechtzigel, Shari Kjos, Lisa Marie Ellich, Adam N Kaplan, Brent C Taylor, Melissa Atwood, Beth A Polsfuss and 2 more

Abstract read
In one paragraph

Article in BMC nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Deborah L PestkaDepartment of Medicine, University of Minnesota, Minneapolis, MN, USA. Pestk003@umn.edu.
Daniel MurphyDepartment of Medicine, University of Minnesota, Minneapolis, MN, USA.
Pearl HuynhMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Jessica A RechtzigelMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Shari KjosMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Lisa Marie EllichMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Adam N KaplanMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Brent C TaylorDepartment of Medicine, University of Minnesota, Minneapolis, MN, USA.
Melissa AtwoodMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Beth A PolsfussMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Joseph Y LeeMinneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
Areef IshaniDepartment of Medicine, University of Minnesota, Minneapolis, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic kidney disease (CKD) are at increased risk for multiple adverse events, several of which have been proven to be less likely with the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i). As a result, guidelines now recommend SGLT2i be given to those with mild to moderate CKD and type 2 diabetes. The objective of this study is to evaluate if a pharmacist-driven SGLT2i prescribing initiative among eligible patients with CKD and diabetes within the VA could more rapidly improve the adoption of SGLT2i via a pragmatic approach aligned with learning health systems.

methodsEligible patients will be identified through an established VA diabetes dashboard. Veterans with an odd social security number (SSN), which is effectively a random number, will be the intervention group. Those with even SSNs will serve as the control while awaiting a second iteration of the same interventional program. The intervention will be implemented in a rolling fashion across one Veterans Integrated Service Network. Our primary outcome is initiation of an SGLT2i. Secondary outcomes will include medication adherence and safety-related outcomes. DISCUSSION: This project tests the impact of a pharmacist-driven medication outreach initiative as a strategy to accelerate initiation of SGLT2i. The results of this work will not only illustrate the effectiveness of this strategy for SGLT2is but may also have implications for increasing other guideline-concordant care. Furthermore, the utilization of SSNs to select Veterans for the first wave of this program has created a pseudo-randomized interventional trial supporting a pragmatic learning health system approach.

trial registrationISRCTN12374636.

Indexed as

Diabetes Mellitus, Type 2Nephrotic SyndromeRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsGlucoseHumansPharmacistsSodiumGlucoseSodiumSodium-Glucose Transporter 2 InhibitorsChronic Kidney DiseaseClinical pharmacy servicesImplementation strategy

Identifiers

PMID38182983
PMCPMC10770983

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Registered trials

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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.