ICD-Pieces, an NIH Pragmatic Trials Collaboratory NIH Collaboratory Trial, aims to improve care for patients with a triad of co-existing conditions: chronic kidney disease, diabetes, and hypertension. Dr. Miguel Vazquez, principal investigator of the ICD-Pieces project, discussed the study in an interview after the NIH Collaboratory’s annual Steering Committee meeting.
ICD-Pieces uses a novel information technology platform to identify patients and deliver evidence-based interventions to improve patient outcomes. Vazquez explained the goal of the study is to reduce emergency department visits, cardiovascular events, and deaths in this patient population. ICD-Pieces has finished enrollment and data collection and is currently analyzing data for its final outcomes.
ICD-Pieces faced several challenges during the course of the study. Vazquez explained, “in the area of recruitment, we enlisted the collaboration of the different sites in helping to enroll more patients.” He said it was important to “have a regular conversation with the different health systems” in order to identify eligible patients. Turnover within the health systems also presented a challenge for the study. “The most important step was to maintain the dialogue with the local health systems and identify local champions to help us to move forward.”
“One of the most important and immediate accomplishments of this study was to advance the research infrastructure that can now be used for other embedded pragmatic trials,” Vazquez said. The ICD-Pieces study was successful in identifying patients with chronic kidney disease, diabetes, and hypertension. “In this day and age it is so important that we include in our trials the patients who actually have the conditions that we want to study.”
Reflecting on the course of the ICD-Pieces study, Vazquez said, “there were some things that we could not have anticipated in terms of planning.” He acknowledged the importance of the NIH Pragmatic Trials Collaboratory in “providing the critical mass of other investigators and trials that are addressing the same questions so we can learn from each other. The Collaboratory was one of the most valuable resources that we had to be able to not only plan, but conduct our study.”
