Cardiometabolic & kidneyRandomised controlled trial
A Nationwide Factorial Randomized Trial of Electronic Nudges to Patients With Chronic Kidney Disease and Their General Practices for Increasing Guideline-Directed Medical Therapy: The NUDGE-CKD Trial
- Randomised controlled trial
- 2×2 factorial
- nationwide
- pragmatic
- implementation trial
- randomisation at patient and general practice level
- Intervention letters delivered on August 19, 2024
- Data from Danish administrative health registries
Authors' conclusion
In this nationwide pragmatic, 2×2 factorial implementation trial, electronic letter-based nudges on GDMT delivered to patients with CKD or their general practice did not increase the uptake of a renin-angiotensin system inhibitor or sodium-glucose cotransporter 2 inhibitor as compared with usual care.
Study context
- Population
- Danish adults with a hospital diagnosis of chronic kidney disease (CKD) and access to the official Danish electronic letter system, and their general practices22,617 patient-level
- Comparison
- Electronic letter-based nudges on guideline-directed medical therapy (GDMT) to patients and/or their general practices vs usual care (no letter)
- Patient nudgen = 11,223
- Usual care (patient level)n = 11,394reference
- Provider lettern = 774 practices (13,959 patients)
- Usual care (practice level)n = 766 practices (14,110 patients)reference
- Primary endpoint
- Filled prescription of a renin-angiotensin system inhibitor or an SGLT2 inhibitor
- Follow-up
- Within 6 months of intervention delivery
Primary result
As reported in the abstract
Difference, percentage points (95% CI)P value
Patient nudge vs Usual care (patient level)
−0.79(−2.03 to 0.45)
P = 0.21Provider letter vs Usual care (practice level)
−0.49(−1.64 to 0.66)
P = 0.41- No interaction between the two interventions
- P for interaction = 0.85
Original publication
A Nationwide Factorial Randomized Trial of Electronic Nudges to Patients With Chronic Kidney Disease and Their General Practices for Increasing Guideline-Directed Medical Therapy: The NUDGE-CKD Trial. Circulation. Published 7 June 2025. doi:10.1161/circulationaha.125.075403
Summarised from the published abstract; every number is checked against it