Abstract: FR-PO115
Feasibility of a Randomized Pilot Trial of a Multidisciplinary AKI Survivor Program in Primary Care
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- May, Heather P., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Griffin, Joan M., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Herges, Joseph, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Kashani, Kianoush, Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- McCoy, Rozalina G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Tinaglia, Angeliki G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
- Barreto, Erin F., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Group or Team Name
- For the ACT Study Group.
Background
AKI survivor care delivery in nephrology specialty clinics has been limited by poor recruitment. The AKI in Care Transitions (ACT) Program was designed to address this barrier by facilitating kidney health follow-up within primary care. This study aimed to describe the recruitment and retention of patients in a clinical trial on the feasibility of ACT compared to usual care.
Methods
The study included adults with stage 3 AKI during hospitalization from 2022-2023 at Mayo Clinic in Rochester, MN, who were expected to discharge to home in the local area, not on dialysis. Consenting individuals were randomized 1:1 to ACT or usual care. Patients in the ACT group received education before discharge and coordination of post-discharge laboratory and clinician (primary care physician [PCP], pharmacist) follow-up in primary care within 14 days. The Usual Care group received no study-specific intervention. The percentage of AKI survivors screened, approached, and who provided consent was reported. Reasons for declining participation were recorded if volunteered. We described the proportion of patients in the ACT group in which pre-discharge education was completed and post-hospital laboratory and clinician follow-up orders were placed.
Results
An electronic health record alert identified 549 potential candidates. There were 429 exclusions based on pre-specified study criteria and 106 individuals were approached for participation. Forty-five (42%) consented to participate and were enrolled. Among 14 patients who declined with a reason, concerns about time commitment and feeling overwhelmed predominated. Of 23 ACT patients, 22 completed education, and 21 had orders placed for post-discharge follow-up. One patient withdrew from the ACT group due to feeling overwhelmed.
Conclusion
These data demonstrate the ability to recruit AKI survivors into a care transitions program within primary care. While ACT recruitment appeared more successful than in other controlled trials of nephrologist follow-up, feeling overwhelmed remained an important barrier to participation. AKI survivor interventions should be simplified where possible to limit treatment burden.
Funding
- Other NIH Support