Education and Training

Primary Care eHealth Intervention for Improved Outcomes in Chronic Kidney Disease

This project seeks to improve the health of patients with chronic kidney disease (CKD) by developing and testing an electronic health intervention (that will combine secure e--mail, smartphone text message, and online video materials) to promote patient use of effective medications. The information we collect on the electronic health intervention will guide future research, including a larger trial and other studies among related patient groups (e.g., racial minorities) and diseases (e.g., type 2 diabetes mellitus). The project has the potential to improve health outcomes for the millions of patients with CKD who are not yet receiving effective medications.

Stanford is currently not accepting patients for this trial.

Intervention(s):

  • other: eHealth Intervention

Eligibility


Inclusion Criteria:

   - Stage 3a (eGFR 45-59) plus poorly controlled risk factors for CKD progression and/or
   cardiovascular disease morbidity/mortality). Our intervention is appropriate for
   patients with stage 3a CKD who are not yet optimized for kidney protection (in the
   setting of proteinuria) with ACE-inhibitors/ARBS, hypertension, diabetes and
   cardiovascular disease treatment. Our intervention messages promote medication classes
   for the optimization of these conditions and thus are appropriate for patients with
   stage 3a CKD who are not yet controlled for these conditions

   - Stage 3b chronic kidney disease (defined as eGFR 30-44): The rationale for including
   patients with stage 3b CKD (defined by eGFR 30-44) but not stage 3a (eGFR 45-59) is to
   reduce the possibility of misclassification of those with higher eGFRs (who have
   little or no underlying kidney dysfunction) and to respond to evidence that patients
   with stage 3b CKD have much higher rates of progression to kidney failure than those
   with stage 3a. We chose the following inclusion criteria to optimize the balance
   between generalizability, participant safety, treatment adherence, and retention.

   - Having a primary care provider (PCP) at UCSF, defined as an identified individual
   provider or provider group from whom the participant receives ongoing medical care, if
   needed;

   - Not pregnant at study assessment.

   - The ability to use a computer or smartphone

   - The ability to understand English

Exclusion Criteria:

   - Severe hypertriglyceridemia (TG>500 mg/dL)

   - Hyperkalemia (K>5.0 mEq/L)

   - Serious illness likely to preclude study completion

   - Pregnancy

   - Intolerance/allergy to all indicated CKD medications

   - Medication management for CKD (i.e., with all of the medications/medication classes
   targeted for promotion by the eHealth intervention) has already been optimized

   - Has never used MyChart: because MyChart use indicates a minimum level of existing
   familiarity with and use of eHealth materials

   - Having no access to a computer or smartphone

   - Plans to change primary care site.

   - Family/household member of another study participant or of a study staff member;

   - Already enrolled or planning to enroll in a research study that would limit full
   participation in this trial or confound interpretation of its results;

   - Investigator discretion for clinical safety or protocol adherence reasons.

Ages Eligible for Study

18 Years - N/A

Genders Eligible for Study

All

Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Veronica Yank, MD
206-459-5316
Not Recruiting