Controlling Hypertension Through Education and Coaching in Kidney Disease

NCT ID: NCT04087798

Last Updated: 2025-04-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-04

Study Completion Date

2025-12-03

Brief Summary

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Chronic kidney disease (CKD) is a serious and growing public health problem. The purpose of this study is to find out if an educational worksheet, called the Encounter Decision Intervention (EDI), combined with health coaching helps CKD patients improve their blood pressure and other health outcomes. The research team hypothesizes that the intervention group will have greater improvement in CKD outcomes than the control group.

Detailed Description

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Patients that meet eligibility criteria and are seen in a clinic assigned to the control group will be given a Control-Encounter Decision Intervention (Control-EDI) about kidney disease in general (not tailored to the patient) by their primary care provider. Eligible patients that agree to participate and give consent will complete enrollment, 1, 6, and 12 month follow-up visits.

Eligible patients that are seen in a clinic assigned to the intervention group will be given a personalized Intervention-EDI by their primary care provider. Following this, eligible patients that agree to participate and give consent will complete the enrollment visit, and have a baseline call with a health coach. In addition to the 1, 6, 12 month follow-up visits these patients will also have approximately 4-6 phone calls with the health coach between the baseline visit and 11 months after enrollment.

In both groups the study team will be collecting medical information and assessments regarding their health; blood sample and urine samples at baseline and 12 months; approximately 4-6 phone calls; as well as surveys at various time points.

In order to reduce in-person human subject activity due to the Coronavirus disease 2019 (COVID-19) pandemic, participants in both groups receive an at home blood pressure monitor so that systolic- \& diastolic-BP data can be collected at all 4 time points (baseline, 1, 6, 12 months). Additionally, we have increased the window tolerance for data collection by a few months for greater flexibility.

We also collect survey data from patients' providers to assess their perception of the intervention's usefulness after patients complete their follow-up study visits. The provider survey data collection will occur up to one year, with an anticipated 100 participating providers. In addition to the 320 patients already enrolled, the study is expected to include a total of 420 participants.

Conditions

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Chronic Kidney Diseases Chronic Disease Chronic Kidney Disease, Stage 3 (Moderate) Chronic Kidney Disease, Stage 4 (Severe) Chronic Kidney Disease Stage 5

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Cluster Randomized Design
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Control

Eligible patients enrolled from the control group clinics will be given a Control-EDI which has information about kidney disease in general (not tailored to the patient) during their clinic visit.

Group Type ACTIVE_COMPARATOR

Control-EDI

Intervention Type BEHAVIORAL

Patients in the control group will receive Control-EDI from their primary care provider during clinic visit. Subsequent patient CKD education and follow-up will be provider dependent. Patients will be called and reminded of their study visits at 1, 6, 12 months to complete study measures, BP checks, and give urine and blood samples (baseline and 12-month visit only).

Intervention

Eligible patients enrolled from the intervention group clinics will be given an Intervention-EDI which has personalized information about kidney disease. There will be space on this for the provider to type in any goals or key points they want the patient to remember. Additionally, patients in this group will also receive health coaching.

Group Type EXPERIMENTAL

Intervention-EDI and health coaching

Intervention Type BEHAVIORAL

Patients in the intervention group will receive a personalized Intervention-EDI from their primary care provider during visit, which will include their most recent BP, their urine protein level and most recent eGFR. There is also a space for their provider to type in a sentence about specific goals for the patient.

Health coaches will conduct a baseline call and 4-6 coaching calls, based on patient's needs, over an 11-month period. There are 4 topic areas related to blood pressure and CKD that will be the focus of the calls. Coaches will also have pre-determined and vetted educational resources to provide patients if needed. Additionally, patients will be called and reminded of their study visits at 1, 6, 12 months to complete study measures, BP checks, and give urine and blood samples (baseline and 12-month visit only).

Interventions

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Control-EDI

Patients in the control group will receive Control-EDI from their primary care provider during clinic visit. Subsequent patient CKD education and follow-up will be provider dependent. Patients will be called and reminded of their study visits at 1, 6, 12 months to complete study measures, BP checks, and give urine and blood samples (baseline and 12-month visit only).

Intervention Type BEHAVIORAL

Intervention-EDI and health coaching

Patients in the intervention group will receive a personalized Intervention-EDI from their primary care provider during visit, which will include their most recent BP, their urine protein level and most recent eGFR. There is also a space for their provider to type in a sentence about specific goals for the patient.

Health coaches will conduct a baseline call and 4-6 coaching calls, based on patient's needs, over an 11-month period. There are 4 topic areas related to blood pressure and CKD that will be the focus of the calls. Coaches will also have pre-determined and vetted educational resources to provide patients if needed. Additionally, patients will be called and reminded of their study visits at 1, 6, 12 months to complete study measures, BP checks, and give urine and blood samples (baseline and 12-month visit only).

Intervention Type BEHAVIORAL

Other Intervention Names

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Control-Encounter Decision Intervention Intervention-Encounter Decision Intervention

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of CKD stage 3, 4, or 5 documented in medical record
* Aware of CKD diagnosis
* Has diagnosis of hypertension documented in medical record and most recent Blood Pressure (BP) within the last year meets criteria of uncontrolled hypertension (≥140 mmHg, and/or a diastolic blood pressure ≥90 mmHg noted in an ambulatory care setting within the past one year)
* Estimated glomerular filtration rate (eGFR) of \<60 within the last 18 months documented in the medical record

Exclusion Criteria

* Currently on dialysis permanently (i.e. are considered "end-stage renal disease" and receiving dialysis)
* Previous kidney transplant
* Pregnant (indicated by medical record or if patient self-identifies as pregnant)
* Has cognitive, language, or vision impairment(s) that would prohibit participating in education, taking surveys, or participating in coaching activities
* Has terminal illness
Minimum Eligible Age

21 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Julie Wright-Nunes

Associate Professor Department of Internal Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Julie Wright, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Michigan / Domino's Farms

Ann Arbor, Michigan, United States

Site Status

University of Michigan / Briarwood Family Medicine

Ann Arbor, Michigan, United States

Site Status

University of Michigan / Brighton Health Center

Brighton, Michigan, United States

Site Status

University of Michigan / Canton Health Center

Canton, Michigan, United States

Site Status

University of Michigan / Chelsea Health Center

Chelsea, Michigan, United States

Site Status

University Health Center - GMAP/Gen Med

Detroit, Michigan, United States

Site Status

University Health Center - Med Peds

Detroit, Michigan, United States

Site Status

University of Michigan / Dexter Health Center

Dexter, Michigan, United States

Site Status

University of Michigan / Livonia Health Center

Livonia, Michigan, United States

Site Status

University of Michigan / Northville Health Center

Northville, Michigan, United States

Site Status

University of Michigan / Ypsilanti Health Center

Ypsilanti, Michigan, United States

Site Status

Countries

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United States

References

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Wright Nunes JA, Resnicow K, Richardson C, Levine D, Kerr E, Saran R, Gillespie B, Bragg-Gresham J, Delacroix EL, Considine S, Fan A, Ellies T, Garcia-Guzman L, Grzyb K, Klinkman M, Rockwell P, Billi J, Martin C, Collier K, Parker-Featherstone E, Bryant N, Seitz M, Lukela J, Brinley FJ, Fagerlin A. Controlling Hypertension through Education and Coaching in Kidney Disease (CHECK-D): protocol of a cluster randomised controlled trial. BMJ Open. 2023 Aug 1;13(8):e071318. doi: 10.1136/bmjopen-2022-071318.

Reference Type DERIVED
PMID: 37527897 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form

View Document

Other Identifiers

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R01DK115844-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HUM00136011

Identifier Type: -

Identifier Source: org_study_id

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