Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol
Abstract Background There are major gaps in the implementation of guideline-concordant care for persons with chronic kidney disease (CKD). The CKD Cascade of Care (C3) initiative seeks to improve CKD care by improving detection and treatment of CKD in primary care. Methods C3 is a multi-modal initia...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12882-022-02943-z |
| _version_ | 1798029971656015872 |
|---|---|
| author | Julio A. Lamprea-Montealegre Priya Joshi Abigail S. Shapiro Erin Madden Krista Navarra O. Alison Potok L. Parker Gregg Tanya Podchiyska Amy Robinson Mary K. Goldstein Carmen A. Peralta Simerjot K. Jassal Sankar D. Navaneethan Dena. E. Rifkin Virginia Wang Michael G. Shlipak Michelle M. Estrella |
| author_facet | Julio A. Lamprea-Montealegre Priya Joshi Abigail S. Shapiro Erin Madden Krista Navarra O. Alison Potok L. Parker Gregg Tanya Podchiyska Amy Robinson Mary K. Goldstein Carmen A. Peralta Simerjot K. Jassal Sankar D. Navaneethan Dena. E. Rifkin Virginia Wang Michael G. Shlipak Michelle M. Estrella |
| author_sort | Julio A. Lamprea-Montealegre |
| collection | DOAJ |
| description | Abstract Background There are major gaps in the implementation of guideline-concordant care for persons with chronic kidney disease (CKD). The CKD Cascade of Care (C3) initiative seeks to improve CKD care by improving detection and treatment of CKD in primary care. Methods C3 is a multi-modal initiative deployed in three major academic medical centers within the Department of Veterans Affairs (VA) Health Care System: San Francisco VA, San Diego VA, and Houston VA. The main objective of the first phase of C3 described in this protocol is to establish the infrastructure for universal CKD detection among primary care patients at high-risk for CKD with a triple-marker screen comprising cystatin C, creatinine, and albuminuria. Across the three sites, a comprehensive educational intervention and the integration of primary care-based clinical champions will be employed with the goal of improving CKD detection and treatment. The San Francisco VA will also implement a practice-facilitation intervention leveraging telehealth and health informatics tools and capabilities for enhanced CKD detection. Parallel formative evaluation across the three sites will assess the feasibility and acceptability of integrating cystatin C as part of routine CKD detection in primary care practice. The effectiveness of the interventions will be assessed using a pre-post observational design for change in the proportion of patients tested annually for CKD. Secondary outcomes will assess change in the initiation of cardio-kidney protective therapies and in nephrology referrals of high-risk patients. Discussion The first phase of C3 is a multi-facility multi-modal initiative that aims to improve CKD care by implementing a triple-marker screen for enhanced CKD detection in primary care. |
| first_indexed | 2024-04-11T19:32:50Z |
| format | Article |
| id | doaj.art-56430e84ea5244afa72d7e2a780492d4 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-04-11T19:32:50Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-56430e84ea5244afa72d7e2a780492d42022-12-22T04:06:56ZengBMCBMC Nephrology1471-23692022-10-0123111010.1186/s12882-022-02943-zImproving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocolJulio A. Lamprea-Montealegre0Priya Joshi1Abigail S. Shapiro2Erin Madden3Krista Navarra4O. Alison Potok5L. Parker Gregg6Tanya Podchiyska7Amy Robinson8Mary K. Goldstein9Carmen A. Peralta10Simerjot K. Jassal11Sankar D. Navaneethan12Dena. E. Rifkin13Virginia Wang14Michael G. Shlipak15Michelle M. Estrella16University of California San FranciscoUniversity of California San FranciscoDuke UniversityKidney Health Research Collaborative, Department of Medicine, University of CaliforniaKidney Health Research Collaborative, Department of Medicine, University of CaliforniaUniversity of California San DiegoBaylor College of Medicine, Michael E. DeBakey VA Medical CenterVA Palo Alto Health Care SystemVA Sierra Pacific Network (VISN 21)VA Palo Alto Health Care SystemUniversity of California San FranciscoUniversity of California San DiegoBaylor College of Medicine, Michael E. DeBakey VA Medical CenterUniversity of California San DiegoDuke UniversityUniversity of California San FranciscoUniversity of California San FranciscoAbstract Background There are major gaps in the implementation of guideline-concordant care for persons with chronic kidney disease (CKD). The CKD Cascade of Care (C3) initiative seeks to improve CKD care by improving detection and treatment of CKD in primary care. Methods C3 is a multi-modal initiative deployed in three major academic medical centers within the Department of Veterans Affairs (VA) Health Care System: San Francisco VA, San Diego VA, and Houston VA. The main objective of the first phase of C3 described in this protocol is to establish the infrastructure for universal CKD detection among primary care patients at high-risk for CKD with a triple-marker screen comprising cystatin C, creatinine, and albuminuria. Across the three sites, a comprehensive educational intervention and the integration of primary care-based clinical champions will be employed with the goal of improving CKD detection and treatment. The San Francisco VA will also implement a practice-facilitation intervention leveraging telehealth and health informatics tools and capabilities for enhanced CKD detection. Parallel formative evaluation across the three sites will assess the feasibility and acceptability of integrating cystatin C as part of routine CKD detection in primary care practice. The effectiveness of the interventions will be assessed using a pre-post observational design for change in the proportion of patients tested annually for CKD. Secondary outcomes will assess change in the initiation of cardio-kidney protective therapies and in nephrology referrals of high-risk patients. Discussion The first phase of C3 is a multi-facility multi-modal initiative that aims to improve CKD care by implementing a triple-marker screen for enhanced CKD detection in primary care.https://doi.org/10.1186/s12882-022-02943-zKidney diseasesCardiovascular diseasesDisease managementImplementation science |
| spellingShingle | Julio A. Lamprea-Montealegre Priya Joshi Abigail S. Shapiro Erin Madden Krista Navarra O. Alison Potok L. Parker Gregg Tanya Podchiyska Amy Robinson Mary K. Goldstein Carmen A. Peralta Simerjot K. Jassal Sankar D. Navaneethan Dena. E. Rifkin Virginia Wang Michael G. Shlipak Michelle M. Estrella Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol BMC Nephrology Kidney diseases Cardiovascular diseases Disease management Implementation science |
| title | Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol |
| title_full | Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol |
| title_fullStr | Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol |
| title_full_unstemmed | Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol |
| title_short | Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol |
| title_sort | improving chronic kidney disease detection and treatment in the united states the chronic kidney disease cascade of care c3 study protocol |
| topic | Kidney diseases Cardiovascular diseases Disease management Implementation science |
| url | https://doi.org/10.1186/s12882-022-02943-z |
| work_keys_str_mv | AT julioalampreamontealegre improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT priyajoshi improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT abigailsshapiro improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT erinmadden improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT kristanavarra improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT oalisonpotok improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT lparkergregg improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT tanyapodchiyska improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT amyrobinson improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT marykgoldstein improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT carmenaperalta improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT simerjotkjassal improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT sankardnavaneethan improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT denaerifkin improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT virginiawang improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT michaelgshlipak improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol AT michellemestrella improvingchronickidneydiseasedetectionandtreatmentintheunitedstatesthechronickidneydiseasecascadeofcarec3studyprotocol |