Acute Kidney Injury In Care Transitions (ACT): Pragmatic Clinical Trial

Purpose

The purpose of this study is to determine the effect of a multidisciplinary intervention at care transitions for acute kidney injury survivors on patient-centered outcomes.

Condition

  • Acute Kidney Injury

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Clinician subjects - Hospital clinicians including physicians and advanced practice providers employed by Mayo Clinic and practicing at one of the four study sites - Provide care for hospitalized patients with stage 2 or stage 3 acute kidney injury (AKI) who are expected to be discharged home and are not receiving dialysis - Patient subjects: - Adults ≥18 years old - Meet KDIGO consensus criteria for stage 2 (moderate) or 3 (severe) AKI - Residence within the study catchment area (southern Minnesota, northern Iowa, or western Wisconsin)

Exclusion Criteria

  • Clinician subjects: Physicians and advanced practice providers who: - Care exclusively for pediatric patients (<18 years) - Care exclusively for patients on palliative care - Patient subjects - Discharged to hospice care - Require outpatient dialysis at discharge - Are admitted from or expected to be discharged to a skilled nursing facility - Dementia Diagnosis - Have undergone solid organ transplant within the past 100 days - Decline authorization for use of their medical records for research

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Prevention
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Acute Kidney Injury in Care Transitions (ACT) Intervention 		Physicians and nurse practitioners randomized to the ACT intervention group will be provided access to augmented kidney care support for acute kidney injury patients prior to hospital discharge, individualized according to post-discharge risk.
  • Behavioral: Acute Kidney Injury in Care Transitions (ACT)
    Clinicians will assign risk-individualized kidney health care prior to hospital discharge for acute kidney injury survivors. Low risk acute kidney injury survivors will receive education prior to hospital discharge, moderate risk acute kidney injury survivors will receive a referral to primary care for laboratory and clinical follow-up within approximately 14-days including a medication review by a pharmacist, and high risk acute kidney injury survivors will be referred to nephrologist-directed care including remote monitoring program (RPM) where available and aligned with the patients goals/values/preferences for up to 90 days after discharge for the highest risk patients.
Active Comparator
Usual Care 		Physicians and nurse practitioners randomized to the usual care group will provide standard of care education, labs, and clinical follow-up after discharge.
  • Behavioral: Usual Care
    Physicians and nurse practitioners will provide standard of care education, labs, and clinical follow-up after discharge.

Recruiting Locations

Mayo Clinic in Rochester
Rochester, Minnesota 55905
Contact:
Mitchell C. Strand
507-293-0952

More Details

Status
Recruiting
Sponsor
Mayo Clinic

Study Contact

Mitchell C. Strand
507-293-0952
strand.mitchell@mayo.edu