Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Improving Evidence-Based Primary Care for Chronic Kidney Disease
Brief Summary: Background: Chronic Kidney Disease (CKD) is under-recognized and under-treated in primary care offices and primary care physicians are generally not familiar with treatment guidelines. Even when diagnosed properly, as a chronic condition CKD is frequently associated with co-morbidities that make effective treatment difficult due to complexity of care. Availability of Clinical Decision Support (CDS) for CKD may help promote effective, evidence-based care, but evidence suggests that CDS alone may not be sufficient for quality improvement and other interventions such as CDS plus practice facilitation may be needed.

Purpose: The project aims to: 1) assess the viability of CDS in implementing evidence-based guidelines for Primary Care Practices (PCPs) and 2) to develop evidence-based practice guidelines that PCPs may use to enhance the care they provide to a difficult to manage segment of the healthcare population.

Methods: This is a randomized controlled trial of point-of-care CDS plus full TRANSLATE model of practice change, versus CDS alone. The study aims to analyze differences in promoting evidence-based care in primary care practices. Thirty-six practices will be recruited for this study. Patient inclusion criteria: adult patients with estimated Glomerular Filtration Rate (eGFR) of \<60 and \>15ml/min/1.73m2 confirmed with repeat testing over three or more months. A process evaluation will be conducted between the CDS practices with facilitation and the CDS only practices to assess clinical outcomes of CKD progression and all-cause mortality. Lastly, a cost-effective analysis will compare the cost-to-benefit ratio of CDS alone to that of CDS plus TRANSLATE (i.e. practice facilitation) in relation to cost per quality adjusted years of life. This study is funded by NIH NIDDK under R01 mechanism starting on 07/01/2011 and ending on 06/30/2016.


Options:
A: Arm Label: Clinical Decision Support for BUP; Type: EXPERIMENTAL; Interventions: Behavioral: Clinical Decision Support (CDS) | Arm Label: Usual Care; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Clinical Decision Support (CDS); Assigned to Arm(s): Clinical Decision Support for BUP
B: Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: HIT Intervention without feedback; Type: EXPERIMENTAL; Interventions: Other: 3-Part Intervention | Arm Label: HIT Intervention with feedback; Type: EXPERIMENTAL; Interventions: Other: 4-Part Intervention | Arm Label: Feedback only; Type: EXPERIMENTAL; Interventions: Other: 1-part intervention | Intervention Type: OTHER; Name: 3-Part Intervention; Assigned to Arm(s): HIT Intervention without feedback | Intervention Type: OTHER; Name: 4-Part Intervention; Assigned to Arm(s): HIT Intervention with feedback | Intervention Type: OTHER; Name: 1-part intervention; Assigned to Arm(s): Feedback only
C: Arm Label: Facilitated Clinical Decision Support; Type: EXPERIMENTAL; Interventions: Other: Facilitated Clinical Decision Support | Arm Label: Clinical Decision Support Only; Type: ACTIVE_COMPARATOR; Interventions: Other: Clinical Decision Support Only | Intervention Type: OTHER; Name: Facilitated Clinical Decision Support; Assigned to Arm(s): Facilitated Clinical Decision Support | Intervention Type: OTHER; Name: Clinical Decision Support Only; Assigned to Arm(s): Clinical Decision Support Only
D: Arm Label: Health-E You App Participants; Type: EXPERIMENTAL; Interventions: Behavioral: Health-E You: a computer-based intervention to improve the use of effective contraception among Hispanic adolescents | Arm Label: Control Group; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Health-E You: a computer-based intervention to improve the use of effective contraception among Hispanic adolescents; Assigned to Arm(s): Health-E You App Participants

Answer: C