Translating CKD Research into Primary Care Practice

将 CKD 研究转化为初级保健实践

• 批准号: 9338235
• 负责人: Cara B. Litvin
• 金额: $ 33.18万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9338235
• 关键词: Abnormal coordination; Adherence; Adopted; Adoption; Awareness; Cardiovascular Diseases; Caring; Chronic Disease; Chronic Kidney Failure; Clinical; Clinical Practice Guideline; Communities; Community Health Centers; Development; Disease; Disease Management; Early identification; Electronic Health Record; Elements; End stage renal failure; Evaluation; Faculty; Funding; Goals; Intervention; Kidney Diseases; Measures; Medical; Modeling; Modification; National Institute of Diabetes and Digestive and Kidney Diseases; Patient Care; Patient risk; Patients; Performance; Play; Primary Care Physician; Primary Health Care; Process; Provider; Randomized Controlled Trials; Recording of previous events; Reporting; Request for Applications; Research; Research Activity; Research Personnel; Residencies; Risk; Risk Factors; Role; Series; South Carolina; System; Testing; Translating; Translational Research; United States; Universities; Work; base; chronic care model; cost efficient; design; evidence base; health information technology; improved; improved outcome; member; practice-based research network; prevent; primary care setting; primary outcome; programs; randomized trial; research to practice; response; rural setting; sound; suburb; support tools

Project Summary/Abstract Primary care providers play a critical role in identifying and managing early chronic kidney disease (CKD) to prevent both development of end stage renal disease and cardiovascular disease. However, large quality gaps exist in the management of CKD in primary care. In response to the NIDDK's request for “translational research to improve outcomes in kidney diseases” (RFA-DK-15-009), the goal of this proposed project is to test the feasibility of using a primary care improvement model that incorporates use of health information technology with delivery system redesign, team care and patient activation strategies to improve adherence to CKD clinical practice guidelines in an eighteen month group randomized trial. The project will be conducted in the Primary Care Practices Research Network (PPRNet), a national primary care practice based research network of members who use electronic health records. The 20 “real world” participating practices will represent a diverse group of patients. Intervention practices will receive reports on adherence to a set of CKD clinical quality measures (CQMs) and participate in activities designed to promote implementation of CKD improvement strategies as guided by the primary care improvement model. Control practices will receive CKD CQM reports. The primary outcomes will be change in practice adherence to CKD CQMs over the 18 month trial. A process evaluation will also be conducted to assess whether the improvement model is implemented as intended. The findings from the project will lead to new evidence on practical and effective approaches for preventing and managing kidney disease in primary care that could be broadly adopted and sustained.

项目总结/摘要 初级保健提供者在识别和管理早期慢性肾脏疾病（CKD）方面发挥着关键作用， 预防终末期肾病和心血管疾病的发展。然而，巨大的质量差距 存在于初级保健中的CKD管理中。根据NIDDK的要求， 改善肾脏疾病结局的研究”（RFA-DK-15-009），本拟议项目的目标是 测试使用初级保健改善模式的可行性，该模式包括使用健康信息 技术与输送系统重新设计，团队护理和患者激活策略，以提高依从性 CKD临床实践指南：一项为期18个月的分组随机试验。该项目将在 初级保健实践研究网络（PPRNet），一个基于国家初级保健实践的研究 使用电子健康记录的成员网络。20个“真实的世界”参与实践将 代表了不同的患者群体。干预实践将收到一组CKD依从性的报告 临床质量措施（CQM），并参与旨在促进CKD实施的活动 以初级保健改善模式为指导的改善战略。控制实践将收到CKD CQM报告。主要结局将是18个月内CKD CQM实践依从性的变化 审判此外，亦会进行过程评估，以评估改善模式的实施是否符合 故意的该项目的研究结果将为以下方面的切实有效办法提供新的证据： 在初级保健中预防和管理肾脏疾病，可以广泛采用和持续。