Electronic Decision-support System to Improve Detection and Care of Patients With Chronic Kidney Disease in Stockholm

Number of participants screened for creatinine and albuminuria,Number of screened participants with retesting for creatinine and albuminuria

One in 10 adults in Region Stockholm have chronic kidney disease (CKD), which dramatically
 increases healthcare costs and the risk of medication errors or adverse health outcomes,
 including cardiovascular disease and death. Identification and early management of these
 patients is done in primary care settings. However, most adults with CKD in our region are
 under detected, undiagnosed and undertreated, with low rates of referral to
 nephrology-specialist care.
 
 This is a pragmatic cluster randomized controlled trial (RCT) involving 66 primary healthcare
 centers in Region Stockholm, and testing the effect of an electronic clinical decision
 support (CDS) triggering system to assist general practitioners through the
 guideline-recommended processes of CKD care.
 
 The centers, providing healthcare to approximately 780.000 citizens, will be randomized 50:50
 to this CDS trigger (vs basic advice) for 18 months. Study outcomes will consider the
 improvement in the indicators of CKD care.
 
 As a pragmatic trial there is no active recruitment or active data collection. The trial is
 embedded into the ongoing Stockholm CREAtinine Measurements (SCREAM) project, a database
 collection of healthcare use for the complete population of Stockholm. Using this real-world
 healthcare data collection, the investigators will be able to measure with precision the
 impact of our CDS trigger and its potential to improve clinical care.