Impact of educational interventions on clinician knowledge, adherence, and satisfaction utilizing a CKD care pathway...

Primary care clinicians are central to early chronic kidney disease (CKD) detection and management, yet often lack structured tools to support guideline-based care. CKD is common, underdiagnosed, and frequently undertreated in primary care, despite guideline-recommended screening and disease-modifying therapies. Structured CKD care pathways may improve clinician knowledge, confidence, and adherence to evidence-based management, yet real-world implementation data remain limited.

A prospective, multi-site pilot study was conducted at 2 health systems implementing a shared CKD Care Pathway with a 3-month educational intervention. Clinicians at the University of Pittsburgh Medical Center (UPMC) Matilda H. Theiss Primary Care Practice and Geisinger Community Medicine Service Line (CMSL) participated in the study. Standardized educational content was delivered at both sites, with implementation tailored to local workflows. Pre- and post-intervention surveys assessed clinician knowledge, confidence, perceived barriers, and satisfaction. Patient-level outcomes and study populations differed by site. At UPMC, electronic medical record (EMR) data were analyzed to assess CKD screening and diagnosis among adults with diabetes, whereas at Geisinger, EMR dashboard data were used to descriptively evaluate sodium-glucose cotransporter-2 inhibitor (SGLT2i) prescribing as a proxy for uptake of guideline-directed therapy in patients at risk of or with CKD.

Clinician confidence improved across multiple CKD identification and management domains. At UPMC, the proportion of patients receiving urine albumin-to-creatinine ratio (uACR) screening increased from 49% pre-intervention to 60% post-intervention at UPMC. At Geisinger, the percentage of patients with diabetes and an active SGLT2i prescription increased descriptively from approximately 17% pre-intervention to approximately 19% during and following the intervention.

A standardized yet adaptable CKD Care Pathway was feasible to implement in primary care and was associated with improved clinician confidence and selected care processes.