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Cardiovascular-Kidney-Metabolic Conditions and Population Health: The Need for an Integrated Care Strategy

Ayodele Odutayo1, Sacha Bhatia2, Peter Blake3

  • 1University of Toronto.

Clinical Journal of the American Society of Nephrology : CJASN
|August 6, 2026
PubMed

Insights

Integrated care programs improve treatment for cardio-kidney-metabolic (CKM) syndrome by addressing patient needs comprehensively. This approach enhances guideline-directed treatment use and population health outcomes for CKM syndrome.

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Disorders
  • Public Health
  • Healthcare Management

Background:

  • Cardio-kidney-metabolic (CKM) syndrome, a prevalent condition combining metabolic, kidney, and cardiovascular issues, poses significant morbidity and mortality risks.
  • Current treatments for CKM syndrome are evolving, offering opportunities to improve patient outcomes and alter disease progression.
  • Clinician-level interventions have shown limited impact on population health for CKM syndrome.

Purpose of the Study:

  • To review evidence supporting integrated care programs as a population health strategy for CKM syndrome.
  • To propose a framework for integrated care programs tailored to CKM syndrome.
  • To achieve the quadruple aim: better patient experience, improved population health, reduced costs, and enhanced provider well-being.

Main Methods:

  • Review of evidence on integrated care programs for CKM syndrome.
  • Analysis of randomized controlled trials demonstrating efficacy.
  • Development of a proposed framework for integrated care delivery.

Main Results:

  • Integrated care programs have shown efficacy in increasing guideline-directed treatment for CKM syndrome in randomized controlled trials.
  • These programs offer a collaborative, person-centered approach to care.
  • Integrated care addresses barriers and improves healthcare capacity and equity.

Conclusions:

  • Integrated care programs represent a promising population health strategy for CKM syndrome.
  • A tailored framework can optimize integrated care delivery for CKM syndrome.
  • Successful implementation can advance the quadruple aim in CKM syndrome management.

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