Sankar D. Navaneethan|Stacey E. Jolly|Jesse D. Schold|Susana Arrigain|Georges Nakhoul|Victoria König|Jennifer Hyland|Yvette K. Burrucker|Priscilla Dann|Barbara Tucky|John W. Sharp|Joseph V. Nally
Pragmatic Randomized, Controlled Trial of Patient Navigators and Enhanced Personal Health Records in CKD
Baylor College of Medicine|Michael E. DeBakey VA Medical Center|Quantitative BioSciences|Cleveland Clinic|Quantitative BioSciences|Cleveland Clinic|Quantitative BioSciences|Cleveland Clinic|Cleveland Clinic|Cleveland Clinic|Cleveland Clinic|Cleveland Clinic
patient navigators enhanced personal health records improve quality health care delivered disease states aimed develop navigator program patients ckd electronic health recordbased enhanced personal health record disseminate ckd stagespecific goals care education also conducted pragmatic randomized clinical trial compare effect navigator program patients ckd enhanced personal health record compare combination compared usual care among patients ckd stage 3b4two hundred nine patients six outpatient clinics primary care nephrology settings randomized 22 factorial design fourstudy groups 1 enhanced personal health record 2 patient navigator 3 4 usual care control group primary outcome measure change egfr 2year followup period secondary outcome measures included acquisition appropriate ckdrelated laboratory measures specialty referrals hospitalization ratesmedian age study population 68 years old 75 white study entry 54 patients followed nephrologists 88 reninangiotensin system blockers 2year followup rate decline egfr similar across four groups p019 measurements ckdrelated laboratory parameters significantly different among groups furthermore referral dialysis education vascular access placement emergency room visits hospitalization rates statistically significant different groupswe successfully developed patient navigator program enhanced personal health record ckd population however differences egfr decline outcomes among study groups larger longterm studies along costeffectiveness analyses needed evaluate role patient navigators patient education enhanced personal health record ckd