Laboratory Corporation of America Holdings (LabCorp) announced the results of a recently published clinical research study that demonstrates improved physician adherence to chronic kidney disease (CKD) treatment guidelines through the use of LabCorp's innovative clinical decision support (CDS) report. Treatment guidelines provide evidence-based information to help physicians and patients better manage diseases and chronic conditions. LabCorp's CDS report presents the CKD guidelines information in an easy-to-use format with clear action steps for the physician and patient to follow.
Chronic kidney disease, a progressive loss of kidney function over time, affects approximately 23 million Americans. The mortality rate for patients with CKD is more than double that for patients without CKD. In its earlier stages, CKD may have no symptoms and can best be detected and managed through routine laboratory testing. As the disease progresses, serious health complications can develop, including cardiovascular disease, anemia, nerve damage, bone pain and weakness, and eventually end-stage kidney disease and kidney failure. When the kidneys fail completely, kidney replacement therapies such as dialysis or transplant are required. Medicare spending for patients with chronic kidney disease exceeds $50 billion annually. Better management of CKD can help to minimize, delay or avoid many of its associated complications, thereby improving patient outcomes and reducing costs.
"Practice guidelines for the treatment of chronic kidney disease help treating physicians provide the best clinical outcomes for their patients," said Mark Brecher, M.D., LabCorp's chief medical officer and a co-author of the study. "This study shows that providing physicians with actionable diagnostic information integrated with healthcare content can change decision making. Although the tests used for chronic kidney disease detection and monitoring are routine, LabCorp's innovative CKD clinical decision support tool is helping physicians to change the way care is provided, and facilitates improved health and improved lives for patients."
Guidelines issued by Kidney Disease: Improving Global Outcomes (KDIGO) and the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF KDOQI) recommend that certain tests be administered within specified timeframes, and that the results of those tests should fall within established ranges. Nephrologists, who are formally trained in CKD care, treat many patients with CKD. However, the large and growing number of CKD patients means that most are cared for by primary care physicians who generally do not have extensive training or experience in the treatment of these patients, and for whom the complex guidelines may be difficult to incorporate into their practice.
The study (Ennis J, Gillen D, Rubenstein A, Worcester E, Brecher ME, Asplin J, Coe F. Clinical decision support improves physician guideline adherence for laboratory monitoring of chronic kidney disease: a matched cohort study. BMC Nephro. 2015; 16:163) assessed whether physician adherence to practice guidelines for the evaluation and management of patients diagnosed with CKD was affected by the physician's receipt of LabCorp's CDS report. The study compared more than 12,000 stage 3 and 4 CKD patients whose physicians received LabCorp's guideline-based CDS reports to almost 43,000 matched control CKD patients whose physicians did not receive the CDS reports on their adherence to these guidelines.
The researchers found that physicians receiving LabCorp's proprietary CDS reports were 29 per cent to 88 percent more likely to order CKD-related testing in accordance with guidelines than those physicians who did not receive the reports. Primary care physicians showed the greatest improvement in guideline adherence following receipt of the CDS report. In addition, nephrologists also showed significant improvement in guideline adherence after receipt of the report. These findings demonstrate that LabCorp's CDS report is an important tool for all physicians responsible for managing the care of patients with CKD and can help to improve outcomes and reduce the costs associated with this disease.
LabCorp's CKD clinical decision support report provides analyses of lab results and treatment guidelines at the point of care. The CDS report was developed by recognized CKD experts, many of whom were members of the guideline development committees, and are routinely updated to reflect the current standard of care. The CDS report also includes patient education tools when requested. Clinicians using LabCorp can opt to receive this type of reporting whenever they order serum creatinine testing and the accompanying estimated Glomerular Filtration Rate (eGFR) result is less than 60, suggesting stage 3 CKD or higher.
The CKD report is part of a suite of proprietary enhanced decision support reports available only from LabCorp to assist clinicians and patients in the management of common chronic diseases, such as cardiovascular disease and diabetes. LabCorp delivered more than 5 million enhanced reports in 2015, a significant increase over prior years.