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(MEnD-AKI) Multicenter Implementation of an Electronic Decision Support System for Drug-associated AKI

Award Number: R01DK121730
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Abstract Acute Kidney Injury (AKI) in the US has increased by 38% over the last eight years, with drugs as a major contributor to AKI in hospitalized patients. Drug-associated AKI (D-AKI) results in severe consequences with approximately 40% of patients experiencing in-hospital death or dialysis dependence and 70% having evidence of residual kidney damage following the initial D-AKI event. We have determined that many patients at high risk for AKI are identified late and often continue to receive nephrotoxic drugs until AKI becomes severe. Thus, we designed a proposal to address the need for early, appropriate management of nephrotoxins in high-risk patients by studying the effect of an advanced clinical decision support system (CDSS) for primary physicians and hospitalists aimed at reducing D-AKI in hospitalized adults. Specifically, we aim to 1) optimize the clinical performance of D-AKI risk-alerts generated by a clinical decision support system; 2) test whether an advanced clinical decision support system coupled with a pharmacist-led intervention improves short and long- term outcomes for patients with D-AKI; and 3) determine physician perception of the pharmacists’ performance, physician acceptance and cost-effectiveness of our intervention. In 2012 Kidney Disease Improving Global Outcomes (KDIGO) published the first comprehensive AKI clinical practice guideline. Recommendations include the use of standard criteria for defining and staging AKI and a series of stage-based management steps to be considered for all patients with AKI or at risk for developing it. However, clinicians have been slow to adopt these recommendations and some groups (most notably the US KDOQI expert panel), while endorsing the guideline overall, have called for more research testing the recommendations. Our proposal directly addresses this concern by testing whether a unique clinical decision support system identifying high risk patients coupled with an advanced pharmacist service directed to the primary physician can address D-AKI and drug dosing for other forms of AKI to improve patient care. Thus, our central goal is to examine the effect of a pharmacist-led intervention on the early detection and management of AKI, progression of and short-term recovery from AKI, and on various AKI-related outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $526,157 )
2024	2024	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	4/9/2024	NON-COMPETING CONTINUATION	$526,157
														Subtotal = $526,157

Issue Date FY: 2023 ( Subtotal = $635,627 )
2023	2023	UNIVERSITY OF PITTSBURGH - OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION	4200 FIFTH AVENUE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	3/17/2023	NON-COMPETING CONTINUATION	$635,627
														Subtotal = $635,627

Issue Date FY: 2022 ( Subtotal = $909,347 )
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	4/13/2022	NON-COMPETING CONTINUATION	$630,467
2022	2022	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	2	8/4/2022	SUPPLEMENT FOR EXPANSION	$278,880
2022	2021	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	12/2/2021	NEW	$0
														Subtotal = $909,347

Issue Date FY: 2021 ( Subtotal = $562,198 )
2021	2021	UNIVERSITY OF PITTSBURGH, THE	4200 5TH AVE	PITTSBURGH	PA	15260	ALLEGHENY	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	5/31/2021	NEW	$562,198
														Subtotal = $562,198

Grand Total All Awards = $2,633,329

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(MEnD-AKI) Multicenter Implementation of an Electronic Decision Support System for Drug-associated AKI

Award Number: R01DK121730

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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