ArticleBMC medical informatics and decision making2026
Provider perspectives of clinical decision support for chronic kidney disease management: a cross-sectional study.
Article in BMC medical informatics and decision making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
14 authors.
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Abstract
backgroundChronic kidney disease (CKD) affects approximately one in ten adults globally. Multiple studies have identified underuse of effective therapies in eligible patients with CKD despite guideline endorsement. Clinical decision support (CDS) may increase confidence in prescribing recommended medications, but how end-users perceive it is unknown.
objectivesTo evaluate clinician-reported perspectives and acceptability of CDS elements for ambulatory CKD management and inform the development of a CKD-specific CDS intervention.
methodsEligible participants for this electronic cross-sectional study were prescribing clinicians from Alberta, Canada, that practiced in ambulatory care settings, including physicians, nurse practitioners, and pharmacists. The survey presented examples of a proposed CDS' content and format, and collected information on clinician demographics, CKD workflows, perceptions of CDS design, perceived acceptability and clinical utility. Knowledge, comfort, and prescribing patterns were examined for renin-angiotensin system inhibitors (RASi), statins, sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), and non-steroidal mineralocorticoid receptor agonists (nsMRA). Participant comfort prescribing each medication class was compared using mean paired differences before and after viewing the proposed CDS.
resultsBetween May and June 2025, 137 clinicians engaged with the survey, 131 completed demographics and 111 completed all survey elements. Most were nephrologists (n = 42; 32%) or general internal medicine specialists (n = 36; 27%). Overall, 88 (79%) supported CDS integration. RASi had the highest self-reported comfort with prescribing followed by statins, SGLT2i, GLP-1RA, and nsMRA. Clinicians reported higher comfort prescribing GLP-1RA and nsMRA with CDS support (median +1 on 9-point scale; p < 0.001), but no change for RASi, statins, and SGLT2i. Participants with low baseline comfort (≤6 on 9-point Likert scale) had statistically significant improvements in comfort with CDS for GLP-1RA and nsMRA (p < 0.05), but no change was observed for those with high baseline comfort.
conclusionsClinicians support CDS integration to enhance CKD care in ambulatory settings. The proposed CDS increased perceived prescribing confidence, particularly for GLP-1RA and nsMRA.
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