A Behaviorally Informed Patient-Facing Intervention to Promote Albuminuria Testing in Hypertension: A Mixed-Methods Evaluation of KnowCKD

KnowCKD, a smartphone-delivered intervention for 57 adults with hypertension, increased EHR-confirmed albuminuria or proteinuria testing to 36.8% versus 11.0% in controls.

• Why it matters: Albuminuria testing is recommended for adults with hypertension to support CKD diagnosis and blood pressure management, yet it is underused partly because patients may not understand its importance. Bridging this knowledge gap could improve testing uptake.
• What they did: KnowCKD used an educational infographic plus brief behavioral messages sent to patients’ smartphones for 5 days around a scheduled primary care visit at one academic medical center. Outcomes included pre/post surveys of CKD awareness and knowledge and EHR-confirmed testing compared with 182 contemporaneous primary care controls using unmatched and propensity score-matched analyses.
• The result: After exposure, recognition of urine testing needs rose from 58% to 95%, knowledge that albuminuria reflects protein in urine rose from 47% to 95%, and awareness that testing enables early CKD detection rose from 55% to 100% (P <0.001 for all). Following the visit, 77% asked their clinician and 65% reported testing was ordered, and testing rates were higher in KnowCKD participants (risk ratio 3.35 [95% CI, 1.96-5.73]).

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