93 Improving Chronic Kidney Disease Care in Primary Care Practices

Abstract

IMPROVING CHRONIC KIDNEY DISEASE CARE IN PRIMARY CARE PRACTICES Chester Fox, Renee Cadzow, Brittany Cooper, Samantha Sessamen, Meredith Snyder, Primary Care Research Institute, Buffalo, New York. The purpose of this study is to improve treatment of CKD in primary care practices by increasing diagnosis of CKD, diagnosing and treating anemia, improving proteinuria with use of ACE/ARB medications, checking for bone disease, treating vitamin D deficiency, and avoiding medicines such as NSAIDS which are harmful to the kidney. Twelve practices have been recruited – 6 were randomly assigned to a basic intervention; 6 to receive an enhanced intervention. All practices received a quick reference guide summarizing the Kidney Disease Outcomes Quality Initiative (KDOQI) chronic kidney disease care guidelines. The 6 enhanced intervention sites were assigned a Practice Enhancement Assistant (PEA) to promote implementation of the guidelines. Six practices also received CINA, a computer point of care decision support protocol engine, which integrates with the practices’ existing electronic health record. Data is collected through manual chart review by a research assistant or PEA at the 6 sites without computer decision support. Data is extracted by CINA at the remaining 6 sites. At sites with support of a PEA, data is reported regularly to the practices throughout the 2 year study as part of the quality improvement cycle. This paper will present baseline, 3 month, and 6 month data for each arm of the study with results of chisquare and t-test analyses demonstrating whether differences exist between participating practices.