Abstract: FR-PO0365
Improving Quality of CKD Care with Individual Performance Reporting and Peer Mentoring: Results from GEMINI Phase 2
Session Information
- Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Kwon, Katherine Westin, Panoramic Health, Tempe, Arizona, United States
- Marcus, Roy G., Panoramic Health, Tempe, Arizona, United States
- Rajpal, Minesh, Southwest Kidney Institute Central Phoenix, Phoenix, Arizona, United States
- Eckhardt, Douglas, Panoramic Health, Tempe, Arizona, United States
- Pu, Jie, Panoramic Health, Tempe, Arizona, United States
Background
The GEMINI project seeks to increase the use of guideline-directed medical therapy (GDMT) for patients with chronic kidney disease (CKD) and Type 2 diabetes (T2D). ACEi/ ARB and SGLT2i are recommended for most patients with CKD and T2D, and nsMRA are recommended in those with albuminuria, yet overall uptake remains low. In GEMINI Phase 1, broad educational outreach across our clinical network led to a significant improvement in the use of SGLT2i. Phase 2 seeks to build on this success, using provider-level performance data and peer to peer coaching; this is the interim analysis of phase 2.
Methods
GEMINI is a quality improvement study in patients with CKD stages 2- 4 and T2D under the care of Panoramic Health aligned nephrologists across 15 states. In Phase 2, a subset of the practices had physicians champion selected; champions receive practice and provider level data on the prescribing rates for ACEi/ ARB, SGLT2i and MRAs on a biweekly basis. Most recent albuminuria results are included with the patient level reporting. Champions are asked to distribute performance data within their practice and engage in individual peer coaching sessions with colleagues. Champions also meet on a regular cadence with study leaders to review progress.
Results
Phase 1 started with 33,806 patients. Rates of GDMT usage as of April 2024 were as follows: ACEi/ARB 77.3%, SGLT2i 40.4%, nsMRA 5.0%. Phase 2 began in March 2025 with 29,254 patients and by April 2025, rates of GDMT usage increased across all categories: ACEi/ARB 78.2% (NS), SGLT2i 47% (p<0.0001), nsMRA 6.4% (p<0.0001). Practices with and without champions showed interval improvement, but champion practices trended towards better performance (Figure 1.)
Conclusion
Timely feedback provided in an easily understandable format, combined with peer accountability, led to improvement of GDMT in this interim analysis. Champion-led practices saw greater gains in SGLT2i and nsMRA use than practices that received standard education. Phase 2 will continue through the end of 2025 to provide insights on sustained efforts from the champions in their practices.
Funding
- Commercial Support – Bayer