Medication Adherence Given Individual SystemCHANGE(TM) in Advancing Nephropathy (MAGICIAN) Pilot Study

Medication Adherence Given Individual SystemCHANGE(TM) in Advancing Nephropathy (MAGICIAN) Pilot Study

The purpose of this 2-group, randomized, controlled trial is to evaluate the refined SystemCHANGE™ against attention control patient education in CKD patients taking RAAS medications.

In this study, the investigators will test a refined SystemCHANGE™ in patients taking RAAS inhibiting medications. Participants will be recruited from two sources: 1) the largest and most comprehensive health care system in the state and 2) one of the largest essential health care systems in the country. Data are collected at baseline, 8 weeks (immediately post-intervention), and 12 weeks.

Inclusion Criteria:

• age > 18 years
• prescribed at least 1 daily RAAS inhibiting medication
• CKD diagnosis estimated glomerular filtration rate (eGFR) category G1 to G4
• RAAS inhibiting medication adherence of <.85 documented during the screening phase
• proteinuria defined as a urine Protein-to-Creatinine ratio > 150 mg/g or urine Albumin-to-Creatinine ratio >30mg/g
• able to speak, hear, and understand English determined by the ability to participate and comprehend conversation about potential inclusion in the study
• self-reported ability to open a pill cap
• able to self-administer RAAS inhibiting medications
• willing to use a study phone
• has no cognitive impairment as determined by a score of 4 or greater on the 6-item Telephone Mental Status Screen Derived from the Mini-Mental Status Exam (cognitive screener)
• has no other diagnoses that may shorten life span, such as metastatic cancer
• is not currently hospitalized
• receives care through two approved health care systems

Exclusion Criteria:

• Participants with kidney failure defined by GFR <15 mL/min/1.73
• Participants will be excluded if they are receiving dialysis or have dialysis access placed (e.g. graft or arteriovenous fistula) in anticipation of starting dialysis.
• Kidney and kidney-pancreas transplant recipients will be excluded.