The Use of Risk Prediction to Identify Patients at Risk for Chronic Kidney Disease (Short Name: RISK [Risk InterventionS for Chronic Kidney Disease])

Summary

This prospective, cluster-randomized trial is structured as a pragmatic study, embedding the outreach intervention within routine clinical workflows. The intervention reflects real-world provider-patient communication methods. The primary research aim is to evaluate, under typical practice conditions, whether structured notification strategies improve follow-up screening. We will evaluate whether targeted provider and patient-directed communication increases completion of CKD disease lab testing (eGFR and uACR) among individuals identified as being at risk for having CKD based on the model developed in in Phase 1. We will identify up to 1,000 patients with high risk of having CKD. All patients' primary care providers (PCPs) will receive a message notifying them of patients' elevated risk status and the recommendation for CKD testing per standard practice. Additionally, we will randomly allocate providers whose patients will receive letters ( \~n=500 patients) and providers whose patients will receive a phone call ( \~n=250 patients).

Eligibility

Age range

18–80 years

Sex

All

Healthy volunteers

Yes

Interventions

• Other
  Letter Intervention

  An estimated 140 PCPs will be randomized, for their patients (\~\<500 patients) to receive the letter via mail, developed by the research team and delivered by USPS. Letters will be

• Other
  Letter + Phone Call Intervention:

  Additionally, approximately 70 providers will be randomized for their patients (\~n\<250) to receive the phone intervention notifying them of their elevated risk and recommending CKD testing.

• Other
  Augmented usual care

  (\~n=280) of 1,000 eligible patients will receive a secure message, developed by the research team and delivered by a research team member with EHR access. The message will notify the PCP of the patients' elevated risk of developing CKD and need for standard CKD testing and provide a smart-set to order eGFR or UACR tests.

Location