Chronic Kidney Disease Clinical Trial
Official title:
A Primary-Secondary Care Partnership to Prevent Adverse Outcomes in Chronic Kidney Disease
Chronic kidney disease (CKD) is a major public health problem with a UK prevalence of 8-10%.
The study hypothesis is to ascertain if intensive primary care led disease management
programmes for CKD, supported by input from secondary care specialists will slow progression
of CKD, improve blood pressure control and reduce cardiovascular events in patients on CKD
registers.
The investigators have partnered with Nene commissioning, a practice based commissioning
group representing approximately 80 GP practices in Northamptonshire, to run this study. This
will be a cluster randomised trial of an intensive, secondary care supported, CKD management
programme in primary care vs normal CKD care. Randomisation will be at the level of the
individual general practice. All general practices associated with Nene commissioning will be
invited to participate. Randomisation of practices will be performed by the University of
Leicester Clinical Trials Unit and the study will adhere to guidelines for undertaking
randomised cluster trials.
The aims of the study are:
1. To determine whether reinforcement of best practice in the management of key aspects of
CKD care by clinical nurse specialists based in primary care, but with close links to
colleagues from secondary care, improves clinical outcomes.
2. To foster excellence in CKD care
3. To improve coding of CKD and prevalence on chronic disease registers.
4. To increase interest in, and capacity for primary care research in Northamptonshire.
5. To implement and evaluate a new model of partnership working between primary and
secondary care.
The primary outcome measures will be changes in estimated glomerular filtration rate (eGFR).
Secondary outcome measures will be blood pressure control, proteinuria, incidence of
cardiovascular events,other biochemical parameters, referrals to secondary care and
hospitalisations and mortality.
see above ;
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