Electronic alert implementation was associated with higher rates of earlier creatinine monitoring in primary care patients with acute kidney disease, according to findings recently published in Clinical Kidney Journal.
“We wanted to establish whether introduction of e-alerts for acute kidney injury led to change in clinician behavior within primary care compared to before the alerts were introduced,” Samira Bell, MBChB, MD, consultant nephrologist and honorary senior clinical lecturer at the University of Dundee in the U.K., told Healio.com/Family Medicine, adding there was “very little work” examining these alerts’ impact in such settings prior to their investigation.
Researchers found prior to electronic alert implementation, 8,812 acute kidney injury episodes were identified, and among those, 30.1% were requested by primary care staff. The median duration to repeat creatinine testing was 55 days (interquartile range [IQR], 20-142) for stage 1 of acute kidney injury, 38 days (IQR, 15-128) for stage 2 and 53 days (IQR, 20-137) for stage 3.
However, during the 12 months after electronic alerts were implemented, 9,781 acute kidney injury e-alerts were generated, of which 14.9% were from primary care staff. The median duration to repeat blood testing for these primary care alerts was 5 days for acute kidney injury stage 1 (IQR, 2-10), 2 days for stage 2 (IQR, 1-5) and 1 day (IQR, 0-2) for stage 3.
Bell and colleagues also found that hospitalization rates within 7 days of acute kidney injury increased from 12.9% pre-alert implementation to 25.5% after (P < .001).
Researchers noted they could not rule out the possibility the higher rates of creatinine monitoring could be attributed to greater awareness of acute injury, rather than the electronic alert. That limitation aside, Bell said the results of their observational study — as opposed to conducting a clinical trial — suggest electronic alerts would be helpful in detecting acute kidney injury in primary care.
“We plan to see if this change in practice has translated into improved patient outcomes since the introduction of the alerts,” she added. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.