Abstract: SA-PO1119
A LUCID Approach to CKD Care Using Collaborative Primary and Secondary Care Virtual Clinics
Session Information
- CKD: Patient-Oriented Care and Case Reports
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Major, Rupert, University of Leicester, Leicester, Leicester, United Kingdom
- Burton, James, University of Leicester, Leicester, Leicester, United Kingdom
Group or Team Name
- LUCID (Leicester, Leicestershire, and Rutland Chronic Kidney Disease Integrated Care Delivery Project).
Background
Most people living with CKD are managed in a traditional primary care setting but more collaborative working with secondary care physicians may improve cardiovascular and ESKD outcomes. Standardized systems for CKD screening at a federal level are currently being considered and incentive systems, such Medicaid’s merit-based incentive payment system value pathways, may face implementation barriers to improving care.
Methods
We developed and implemented a novel education and virtual CKD service in the UK - “The Leicester, Leicestershire, and RUtland Chronic Kidney Disease Integrated Care Delivery Project” (LUCID) - across an area of ~1.2 million people with ~60,000 people living with CKD.
The programme focused on four core LUCID principles for people living with CKD:
1. Identification of cases at a population level
2. Optimisation of guideline directed medical therapy
3. Surveillance of the known CKD population
4. Education for public and professionals
Results
In April 2022 virtual clinics were piloted in an area of ~150,000 people with the focus on the four key principles including education during virtual clinics. Virtual clinics were delivered by an attending nephrologist in collaboration with primary care physicians and pharmacists. The program was expanded in April 2023 to make virtual clinics available to 130 primary care practices with support via an EHR-based CKD dashboard to support the four LUCID principles.
Upto 1st April 2024, 1341 consultations have occurred across 102 virtual clinics. 590 episodes of medicines optimisation (Figure 1) have occurred for people living with CKD and often other co-morbidities such as hypertension (75%), diabetes (56%) and heart failure (14%).
Conclusion
LUCID can lead to the delivery of identification, optimization, surveillance and education for people living with CKD and other co-morbidities at a population level. LUCID may represent a clinical model that can promote efficient care, especially in the context of Medicaid’s incentive systems and if federal CKD screening were to be implemented.
Funding
- Commercial Support – AstraZeneca UK