Baylor Research Institute
The goal of this pragmatic randomized clinical trial is to determine whether an Epic-based clinician notification increases initiation of guideline-directed cardio-kidney-metabolic (CKM) therapies in adults with type 2 diabetes and confirmed albuminuria. The main question it aims to answer is: • Does an Epic clinician notification improve initiation of guideline-directed CKM therapies compared with usual care? Researchers will compare an Epic in-basket clinician notification strategy with usual care. In the intervention arm, the treating clinician will receive an Epic notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing electronic health record (EHR) data. Participants in the usual care arm will receive standard clinical care without notification.
This study is a pragmatic, randomized, EHR-embedded implementation trial designed to evaluate whether an Epic-based clinician notification improves initiation of guideline-directed CKM therapies in adults with type 2 diabetes and confirmed albuminuria. Despite contemporary guideline recommendations, substantial gaps remain in urine albumin-to-creatinine ratio (UACR) screening, confirmatory testing, and initiation of evidence-based CKM therapies, including renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor an…
Inclusion Criteria * Adults aged ≥18 years * Diagnosis of type 2 diabetes mellitus * Receiving outpatient care within Baylor Scott \& White Health * At least 1 outpatient encounter within the preceding 12 months * Confirmed albuminuria (UACR \>30 mg/g) * Eligible for one or more guideline-directed CKM therapies based on - prespecified clinical criteria and EHR review Exclusion Criteria: * Type 1 diabetes mellitus * Contraindication or documented intolerance to all eligible guideline-directed CKM therapies * Advanced kidney dysfunction below recommended initiation thresholds for SGLT2i or fi…
Epic in-basket clinician notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing EHR data.
Standard clinical care without Epic clinician notification.
Arctuva estimate
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