权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

(MEnD-AKI) Multicenter Implementation of an Electronic Decision Support System for Drug-associated AKI

(MEnD-AKI) 药物相关 AKI 电子决策支持系统的多中心实施

基本信息

批准号：
10209005
负责人：
Azra Bihorac
金额：
$ 56.22万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-01 至 2026-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10209005
关键词：
Accounting Acute Renal Failure with Renal Papillary Necrosis Address Adopted Adult Adverse drug event Caring Cessation of life Chronic Clinical Clinical Decision Support Systems Clinical Practice Guideline Computerized Medical Record Cost Analysis Coupled Data Decision Support Systems Dependence Development Diagnostic Dialysis procedure Dose Drug Modelings Early Diagnosis Effectiveness Etiology Event Goals Guidelines Health system Hospitalists Hospitals Incidence Injury to Kidney Intervention Kidney Diseases Laboratories Length of Stay Light Machine Learning Measures Medical center Operative Surgical Procedures Outcome Patient Care Patient-Focused Outcomes Patients Perception Performance Pharmaceutical Preparations Pharmacists Physicians Predictive Analytics Predictive Value Provider Publishing Randomized Randomized Controlled Trials Recommendation Recovery Reporting Research Residual state Risk Risk Assessment Sensitivity and Specificity Series Services Site Staging Surveys System Testing Therapeutic Intervention Time United States Universities Update aging population base care providers clinical decision support clinical risk comorbidity control trial cost cost effectiveness design detection platform effectiveness evaluation equipment training experience group intervention high risk imaging agent implementation cost implementation intervention improved innovation mortality nephrotoxicity non-drug post intervention premature renal damage risk prediction model standard of care

项目摘要

Abstract Acute Kidney Injury (AKI) in the US has increased by 38% over the last eight years, with drugs as a major contributor to AKI in hospitalized patients. Drug-associated AKI (D-AKI) results in severe consequences with approximately 40% of patients experiencing in-hospital death or dialysis dependence and 70% having evidence of residual kidney damage following the initial D-AKI event. We have determined that many patients at high risk for AKI are identified late and often continue to receive nephrotoxic drugs until AKI becomes severe. Thus, we designed a proposal to address the need for early, appropriate management of nephrotoxins in high-risk patients by studying the effect of an advanced clinical decision support system (CDSS) for primary physicians and hospitalists aimed at reducing D-AKI in hospitalized adults. Specifically, we aim to 1) optimize the clinical performance of D-AKI risk-alerts generated by a clinical decision support system; 2) test whether an advanced clinical decision support system coupled with a pharmacist-led intervention improves short and long- term outcomes for patients with D-AKI; and 3) determine physician perception of the pharmacists’ performance, physician acceptance and cost-effectiveness of our intervention. In 2012 Kidney Disease Improving Global Outcomes (KDIGO) published the first comprehensive AKI clinical practice guideline. Recommendations include the use of standard criteria for defining and staging AKI and a series of stage-based management steps to be considered for all patients with AKI or at risk for developing it. However, clinicians have been slow to adopt these recommendations and some groups (most notably the US KDOQI expert panel), while endorsing the guideline overall, have called for more research testing the recommendations. Our proposal directly addresses this concern by testing whether a unique clinical decision support system identifying high risk patients coupled with an advanced pharmacist service directed to the primary physician can address D-AKI and drug dosing for other forms of AKI to improve patient care. Thus, our central goal is to examine the effect of a pharmacist-led intervention on the early detection and management of AKI, progression of and short-term recovery from AKI, and on various AKI-related outcomes.

摘要