Electronic Alerts to Help Doctors Update Medicines for Heart, Kidney and Metabolic Conditions
Tests health record alerts for better prescribing in adults with heart, kidney and diabetes conditions.
Plain-language title generated from the registry record
Registry title: SWitching to Appropriate Prescription in Cardiovascular-Kidney-Metabolic Syndrome
Key facts
- Where
- Pleasanton, United StatesSee the site
Where in United States
- Kaiser Permenante Division of ResearchPleasanton, United StatesNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Kaiser Permanente
- Trial code
- NCT07910968
- Record updated
- 2 November 2026
- Original description
SWAP-CKM (SWitching to Appropriate Prescription in Cardiovascular-Kidney-Metabolic Syndrome) is a pragmatic, cluster-randomized clinical trial designed to evaluate whether electronic health record (EHR)-based alerts can improve medication prescribing among adults with cardiovascular, kidney, and metabolic (CKM) conditions.Read full original descriptionShow less
SWitching to Appropriate Prescription in Cardiovascular-Kidney-Metabolic Syndrome
SWAP-CKM (SWitching to Appropriate Prescription in Cardiovascular-Kidney-Metabolic Syndrome) is a pragmatic, cluster-randomized clinical trial designed to evaluate whether electronic health record (EHR)-based alerts can improve medication prescribing among adults with cardiovascular, kidney, and metabolic (CKM) conditions.
The study will include all eligible adult patients receiving care within Kaiser Permanente Northern California (KPNC) who have CKM conditions and opportunities for therapeutic medication substitution. Fifteen service areas are randomly assigned to either an intervention group or a usual care group.
Clinicians in the intervention group will receive EHR-based Best Practice Advisories (BPAs) identifying opportunities to replace potentially inappropriate medications with guideline-recommended therapies. The intervention may also include audit-and-feedback reports to support medication optimization. Clinicians retain full discretion over treatment decisions.
The primary outcome is the proportion of eligible therapeutic optimization opportunities achieved at 9 months. Secondary outcomes include medication initiation and discontinuation, medication optimization at 18 months, and polypharmacy burden.
Inclusion: Age >=18 years; Presence of appropriate CKM condition; Eligible for at least one therapeutic swap; Outpatient encounter, including in-person or telehealth care, with an eligible clinician during the study period.
Exclusion: Currently on dialysis; Receiving hospice care; Prior history of LVAD, heart transplantation, or any solid organ transplantation; Membership at KPNC < 6 months.