[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100640562":3},{"organization":4,"outcomesModule":7,"designInfo":31,"detailedDescription":37,"studyPopulation":30,"armGroups":38,"interventions":51,"overallOfficials":59,"centralContacts":64,"locations":69,"responsibleParty":96,"collaborators":30,"id":98,"slug":30,"hasResults":99,"nctId":100,"briefTitle":101,"officialTitle":102,"acronym":30,"eligibilityCriteria":103,"healthyVolunteers":99,"sex":104,"minAge":105,"maxAge":30,"enrollmentInfo":106,"targetDuration":30,"studyType":109,"phases":110,"briefSummary":112,"conditions":113,"keywords":116,"overallStatus":131,"whyStopped":30,"lastUpdateSubmitDate":132,"lastUpdatePostDateStruct":133,"startDateStruct":136,"completionDateStruct":138,"leadSponsor":140,"locationsCount":141},{"fullName":5,"class":6},"Baylor Research Institute","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":16,"otherOutcomes":30},[9,13],{"measure":10,"description":11,"timeFrame":12},"Initiation of Guideline-Directed Cardio-Kidney Metabolic Therapy","Proportion of eligible participants newly prescribed one or more guideline-directed cardio-kidney-metabolic (CKM) therapies, including renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonists (ns-MRA), or glucagon-like peptide-1 receptor agonists (GLP-1RA) as assessed using electronic health record (EHR) data.","3 months",{"measure":14,"description":15,"timeFrame":12},"Therapy-Specific Initiation Rate","Proportion of participants eligible for a specific CKM therapy who were newly prescribed each individual guideline-directed CKM therapy class (RASi, SGLT2i, ns-MRA, or GLP-1RA), as assessed using electronic health record (EHR) data.",[17,20,24,27],{"measure":18,"description":19,"timeFrame":12},"Time to Guideline-Directed Therapy Initiation","Time from randomization to initiation of one or more eligible guideline-directed CKM therapies, assessed using electronic health record (EHR) prescribing data.",{"measure":21,"description":22,"timeFrame":23},"Repeat Epic Notification Frequency","Proportion of participants requiring repeat Epic clinician notification due to absence of documented therapy initiation or clinician response within 30 days of the initial notification, as assessed using electronic health record (EHR) data.","30 days",{"measure":25,"description":26,"timeFrame":12},"Clinician Reach","Proportion of eligible clinicians who received Epic-based CKM notifications, as assessed using electronic health record (EHR) notification metadata.",{"measure":28,"description":29,"timeFrame":23},"Clinician Response to Epic Notification","Proportion of Epic clinician notifications associated with documented clinician acknowledgment, therapy initiation, or therapy deferral, as assessed using electronic health record (EHR) data.",null,{"allocation":32,"interventionModel":33,"interventionModelDescription":30,"primaryPurpose":34,"observationalModel":30,"timePerspective":30,"maskingInfo":35},"RANDOMIZED","PARALLEL","TREATMENT",{"masking":36,"maskingDescription":30,"whoMasked":30},"NONE","This study is a pragmatic, randomized, EHR-embedded implementation trial designed to evaluate whether an Epic-based clinician notification improves initiation of guideline-directed CKM therapies in adults with type 2 diabetes and confirmed albuminuria.\n\nDespite contemporary guideline recommendations, substantial gaps remain in urine albumin-to-creatinine ratio (UACR) screening, confirmatory testing, and initiation of evidence-based CKM therapies, including renin-angiotensin system inhibitors (RASi), sodium-glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonists (ns-MRA), and glucagon-like peptide-1 receptor agonists (GLP-1RA). Health-system workflows frequently fail to translate identification of albuminuria-associated CKM risk into timely initiation of disease-modifying therapy.\n\nEligible participants will be randomized in a 1:1 ratio to either usual care or an Epic-based clinician notification strategy.\n\nIn the intervention arm, the treating clinician will receive an Epic in-basket message identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing EHR data. All treatment decisions will remain at the discretion of the treating clinician.\n\nThe primary endpoint is initiation of one or more eligible guideline-directed CKM therapies within 3 months of randomization.\n\nThis study will provide important implementation data regarding whether low-burden EHR-based clinician notifications can improve evidence-based CKM care in real-world clinical practice settings.",[39,45],{"label":40,"type":41,"description":42,"interventionNames":43},"Epic Clinician Notification","EXPERIMENTAL","Treating clinicians receive an Epic in-basket notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing EHR data. All treatment decisions remain at the discretion of the treating clinician.",[44],"Other: Epic-Based Clinician Notification",{"label":46,"type":47,"description":48,"interventionNames":49},"Usual Care","ACTIVE_COMPARATOR","Participants receive standard clinical care without Epic clinician notification. Treatment decisions, including initiation of guideline-directed CKM therapies, remain at the discretion of the treating clinician.",[50],"Other: Usual Care",[52,56],{"type":6,"name":53,"description":54,"armGroupLabels":55,"otherNames":30},"Epic-Based Clinician Notification","Epic in-basket clinician notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing EHR data.",[40],{"type":6,"name":46,"description":57,"armGroupLabels":58,"otherNames":30},"Standard clinical care without Epic clinician notification.",[46],[60],{"name":61,"affiliation":62,"role":63},"Shahzeb Khan, MD","Baylor Scott and White Health","PRINCIPAL_INVESTIGATOR",[65],{"name":61,"role":66,"phone":67,"phoneExt":30,"email":68},"CONTACT","469-326-2636","shahzeb.khan@bswhealth.org",[70,84],{"facility":62,"status":30,"city":71,"state":72,"zip":73,"country":74,"countryCode":75,"cosmosGeoPoint":76,"geoPoint":81,"contacts":82},"Dallas","Texas","75246","United States","US",{"type":77,"coordinates":78},"Point",[79,80],-96.80667,32.78306,{"lat":80,"lon":79},[83],{"name":61,"role":66,"phone":67,"phoneExt":30,"email":68},{"facility":85,"status":30,"city":86,"state":72,"zip":87,"country":74,"countryCode":75,"cosmosGeoPoint":88,"geoPoint":92,"contacts":93},"Baylor Scott and White, Advanced Heart Care","Plano","75093",{"type":77,"coordinates":89},[90,91],-96.69889,33.01984,{"lat":91,"lon":90},[94,95],{"name":61,"role":66,"phone":67,"phoneExt":30,"email":68},{"name":61,"role":63,"phone":30,"phoneExt":30,"email":30},{"type":97,"investigatorFullName":30,"investigatorTitle":30,"investigatorAffiliation":30,"oldNameTitle":30,"oldOrganization":30},"SPONSOR","100640562",false,"NCT07605390","RAndomized EHR-based Prescribing to Improve Disease-modifying Therapies for Cardio-Kidney-Metabolic Care (RAPID-CKM)","RAPID-CKM: RAndomized EHR-based Prescribing to Improve Disease-modifying Therapies for Cardio-Kidney-Metabolic Care.","Inclusion Criteria\n\n* Adults aged ≥18 years\n* Diagnosis of type 2 diabetes mellitus\n* Receiving outpatient care within Baylor Scott \\& White Health\n* At least 1 outpatient encounter within the preceding 12 months\n* Confirmed albuminuria (UACR \\>30 mg\u002Fg)\n* Eligible for one or more guideline-directed CKM therapies based on - prespecified clinical criteria and EHR review\n\nExclusion Criteria:\n\n* Type 1 diabetes mellitus\n* Contraindication or documented intolerance to all eligible guideline-directed CKM therapies\n* Advanced kidney dysfunction below recommended initiation thresholds for SGLT2i or finerenone\n* Hyperkalemia or elevated baseline serum potassium precluding safe therapy initiation\n* Contraindicated drug interactions (e.g., strong CYP3A inhibitors with finerenone)\n* Other guideline- or labeling-based contraindications to therapy initiation","ALL","18 Years",{"count":107,"type":108},600,"ESTIMATED","INTERVENTIONAL",[111],"NA","The goal of this pragmatic randomized clinical trial is to determine whether an Epic-based clinician notification increases initiation of guideline-directed cardio-kidney-metabolic (CKM) therapies in adults with type 2 diabetes and confirmed albuminuria.\n\nThe main question it aims to answer is:\n\n• Does an Epic clinician notification improve initiation of guideline-directed CKM therapies compared with usual care?\n\nResearchers will compare an Epic in-basket clinician notification strategy with usual care.\n\nIn the intervention arm, the treating clinician will receive an Epic notification identifying confirmed albuminuria and potential eligibility for guideline-directed CKM therapies using existing electronic health record (EHR) data. Participants in the usual care arm will receive standard clinical care without notification.",[114,115],"Chronic Kidney Disease","Type 2 Diabetes",[117,118,119,120,121,122,123,124,125,126,127,128,129,130,115,114],"Cardio-Kidney-Metabolic Syndrome","Albuminuria","Urine Albumin-to-Creatinine Ratio","Guideline-Directed Medical Therapy","Electronic Health Record","Epic","Implementation Science","Pragmatic Trial","Renin-Angiotensin System Inhibitors","Sodium-Glucose Cotransporter-2 Inhibitors","Glucagon-Like Peptide-1 Receptor Agonists","Non-steroidal Mineralocorticoid Receptor Antagonists","Finerenone","CKM Care","NOT_YET_RECRUITING","2026-05-19",{"date":134,"type":135},"2026-05-26","ACTUAL",{"date":137,"type":108},"2026-08",{"date":139,"type":108},"2028-01",{"name":5,"class":6},2]