Abstract: PO2056
Workplace Outreach Program Facilitates Referral into Physician Care and Diagnosis of CKD
Session Information
- Health Maintenance, Nutrition, and Metabolism: Clinical
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Authors
- Iakoubova, Olga A., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Tong, Carmen H., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Rowland, Charles M., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Arellano, Andre, Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Bare, Lance A., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Fragala, Maren S., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Devlin, James J., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
- Birse, Charles E., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
Background
Chronic kidney disease (CKD) is often unrecognized and undertreated. Timely diagnosis can improve disease management and slow CKD progression. We asked whether a workplace outreach program facilitates CKD diagnosis and improves management of CKD.
Methods
An annual workplace health assessment that included eGFR testing was offered to employees. Those with confirmed CKD by repeat eGFR <60 mL/min/1.73 m2 or by albumin to creatinine ratio test were eligible to participate in a CKD outreach program. A study coordinator made up to 3 phone calls in an effort to contact each eligible employee, to provide an explanation of CKD risk and to offer a physician consultation to discuss test results and referral into care. Those who accepted the phone call (participation group) were compared to those who were not reached by phone (control group). Using logistic regression models that adjusted for prevalent CKD, we analyzed claims data to estimate the effect of outreach participation on nephrologist visits, physician visits, and new CKD diagnoses 5 months after the outreach. Changes in eGFR levels were evaluated at the following annual health assessment.
Results
Of the 398 eligible employees, 156 participated in the outreach program; the remaining 242 served as the control group. CKD risk factor profiles at baseline were similar between participants and controls. Participants had 3-fold greater odds of visiting nephrologists, 60% greater odds of visiting physicians and 80% greater odds of being diagnosed with CKD, compared with the controls. Participants had 40% lower odds of an annual eGFR decline >5 ml/min/1.73 m2 compared with controls (Table). One participant initiated kidney dialysis, compared with none in the control group.
Conclusion
A workforce CKD outreach program facilitates diagnosis of CKD and improves disease management including referral to a nephrologist.
Effect of the CKD Outreach Program on Disease Management
| Outcome | Adjusted Odds Ratio | 95% CI | P value |
| Nephrologist visits | 3.0 | 1.38 - 6.77 | 0.006 |
| Physician visits | 1.61 | 1.07 - 2.42 | 0.023 |
| Newly diagnosed CKD | 1.83 | 1.05 - 3.10 | 0.034 |
| Annual eGFR decline >5 ml/min/1.73 m2 | 0.59 | 0.32-1.09 | 0.095 |
Funding
- Commercial Support – Quest Diagnostics supports annual health assessments and the CKD outreach program for employees and their spouses. It also provided funds for the analysis presented in the abstract