Kidney Week

Abstract: FR-PO0135

Evaluating Multidisciplinary Post-AKI Care Delivery in Primary Care: Videographic Analysis of the ACT Program

Session Information

• AKI: Epidemiology and Clinical Trials
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• May, Heather P., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Heather P. May, PharmD, MSc

• Determan, Meina Louise, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Meina Louise Determan, PharmD

• Ledet, Caroline B., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Caroline B. Ledet, MD

• Griffin, Joan M., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Joan M. Griffin, PhD

• Kashani, Kianoush, Mayo Clinic Minnesota, Rochester, Minnesota, United States

Kianoush Kashani, MD, MS, FASN

• Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Andrea G. Kattah, MD, MS

• McCoy, Rozalina G., University of Maryland School of Public Health, College Park, Maryland, United States

Rozalina G. McCoy, MD, MS

• Rule, Andrew D., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Andrew D. Rule, MD, MS, FASN

• Barreto, Erin F., Mayo Clinic Minnesota, Rochester, Minnesota, United States

Erin F. Barreto, PharmD, PhD, FASN

Group or Team Name

• For the ACT Study Group.

Background

AKI survivorship programs aim to close care gaps and promote adherence to best-practice recommendations for kidney health. We studied how post-AKI kidney health care was provided by a multidisciplinary team in primary care through the AKI in Care Transitions (ACT) Program.

Methods

This was a mixed methods, videographic analysis of post-discharge clinical encounters between patients and a primary care provider (PCP) and/or pharmacist, recorded as part of a randomized clinical trial of the ACT Program. ACT included adults with stage 3 AKI during hospitalization who were discharged locally to home not on dialysis. Patients in the ACT arm and their consenting providers had post-discharge encounters videotaped. Recordings were reviewed independently by 3 investigators using an observation template. Quantitative data included the proportion of visit time focused on kidney health, specifically the KAMPS framework domains (Kidney function check, Advocacy [education, communication], Medications, blood Pressure, Sick day protocols), which were used for deductive coding of observers’ field notes to identify emerging themes.

Results

Ten of 25 ACT participants had an encounter recorded (PCP N=9; pharmacist N=7). Median (IQR) visit time was 24 (22, 33) minutes and 25 (17, 35) minutes for PCPs and pharmacists, respectively. Issues related to kidney health were discussed for 24% (16, 26) of PCP visits and 75% (70, 94) of pharmacist visits (p<0.001). PCPs discussed kidney function laboratory testing and follow up (20% and 11% of visit time, respectively). Pharmacists emphasized medication reconciliation and education (50% and 25% of visit time, respectively). Qualitative observations noted verbalization of individualized blood pressure goals and discussion of the relationship between blood pressure and kidney health were infrequent. Among patients who recovered kidney function, dialogue about KAMPS criteria was often absent or brief.

Conclusion

Multidisciplinary collaboration facilitated uptake of post-AKI care best practices in primary care. Consistent application of the full KAMPS framework was lacking, particularly for patients who recovered kidney function. Opportunities to improve care individualization and make kidney health connections for patients exist.

Funding

• Other NIH Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20258j349wp2