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Kidney Week

Abstract: PO2056

Workplace Outreach Program Facilitates Referral into Physician Care and Diagnosis of CKD

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Iakoubova, Olga A., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Tong, Carmen H., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Rowland, Charles M., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Arellano, Andre, Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Bare, Lance A., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Fragala, Maren S., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Devlin, James J., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
  • Birse, Charles E., Quest Diagnostics Nichols Institute, San Juan Capistrano, California, United States
Background

Chronic kidney disease (CKD) is often unrecognized and undertreated. Timely diagnosis can improve disease management and slow CKD progression. We asked whether a workplace outreach program facilitates CKD diagnosis and improves management of CKD.

Methods

An annual workplace health assessment that included eGFR testing was offered to employees. Those with confirmed CKD by repeat eGFR <60 mL/min/1.73 m2 or by albumin to creatinine ratio test were eligible to participate in a CKD outreach program. A study coordinator made up to 3 phone calls in an effort to contact each eligible employee, to provide an explanation of CKD risk and to offer a physician consultation to discuss test results and referral into care. Those who accepted the phone call (participation group) were compared to those who were not reached by phone (control group). Using logistic regression models that adjusted for prevalent CKD, we analyzed claims data to estimate the effect of outreach participation on nephrologist visits, physician visits, and new CKD diagnoses 5 months after the outreach. Changes in eGFR levels were evaluated at the following annual health assessment.

Results

Of the 398 eligible employees, 156 participated in the outreach program; the remaining 242 served as the control group. CKD risk factor profiles at baseline were similar between participants and controls. Participants had 3-fold greater odds of visiting nephrologists, 60% greater odds of visiting physicians and 80% greater odds of being diagnosed with CKD, compared with the controls. Participants had 40% lower odds of an annual eGFR decline >5 ml/min/1.73 m2 compared with controls (Table). One participant initiated kidney dialysis, compared with none in the control group.

Conclusion

A workforce CKD outreach program facilitates diagnosis of CKD and improves disease management including referral to a nephrologist.

Effect of the CKD Outreach Program on Disease Management
OutcomeAdjusted Odds Ratio95% CIP value
Nephrologist visits3.01.38 - 6.770.006
Physician visits1.611.07 - 2.420.023
Newly diagnosed CKD1.831.05 - 3.100.034
Annual eGFR decline >5 ml/min/1.73 m20.590.32-1.090.095

Funding

  • Commercial Support