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慢性腎臓疾患の患者に対する電子ナッジの全国的因子ランダム化試験と,ガイドライン指向の医療療法を増やすための一般的な実践:NUDGE-CKD試験
Kristoffer Grundtvig Skaarup1,2, Niklas Dyrby Johansen1,2, Lisbet Brandi3,4
1Departments of Cardiology (K.G.S., N.D.J., D.M., M.C.H.L., K.H.J., T.B.-S.), Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
Circulation
|June 7, 2025
PubMed で要約を見る
まとめ
慢性腎臓病 (CKD) の患者またはその医師に対する電子ドッダーは,ガイドライン指向医療療法 (GDMT) の摂取を改善しませんでした. この研究は,CKD患者に対するGDMTの実施における課題を強調しています.
科学分野:
- 腎臓科
- 実施科学
- 心血管医学
背景:
- 慢性腎臓病 (CKD) の患者では,心血管および腎臓のアウトカムに重大な,変更可能なリスクがある.
- 慢性腎臓病の管理におけるGDMTの吸収を改善するための戦略として,電子ドッジが検討されました.
研究 の 目的:
- 慢性腎臓病患者およびその一般診療におけるGDMTの摂取増加における電子的な手紙ベースのドッダルの有効性を調査する.
主な方法:
- ランダム化された患者と一般診療での全国的な2x2因子実施試験.
- GDMTに関する患者レベルでの電子的なスナップと,提供者レベルでの情報書簡が含まれていました.
- 主なエンドポイントは,レニン- 血管新生システム阻害剤またはナトリウム- グルコース共輸送体2阻害剤を6ヶ月以内に処方したことです.
主要な成果:
- 患者レベルでのドッジは,GDMT摂取の有意な増加を示さなかった (65. 1% vs 65. 9%).
- 提供者レベルのドッジは,GDMTの摂取を有意に増加させなかった (63. 9% vs 64. 4%).
- 患者と医療従事者の間には有意な相互作用は見られなかった.
結論:
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