One million people in the UK are in the early stages of chronic kidney disease, but don’t know it yet. The solution to increasing testing rates and finding the “missing million” is right in their pockets.
People suffering from CKD experience gradual deterioration of their kidney function. Without early treatment, their kidneys can eventually fail entirely, and require dialysis or transplant. They also have a higher risk of developing cardiovascular disease.
CKD usually exhibits few symptoms in its early stages. But a simple urine test can help with early detection, allowing for treatment that can prevent it from progressing to its dangerous and costly late stages. The National Institute for Health and Care Excellence (NICE) recommends that people with hypertension or diabetes–the populations with the highest risk for developing CKD–do an annual test measuring the ratio of albumin to creatinine (ACR) in their urine, which is an early indicator of CKD.
Unless they undergo the recommended screening, by the time the members of the so-called “missing million” discover their disease, it may have progressed to its later stages. Early detection can also help avoid the more complicated drugs and treatment necessary in the disease’s later stages.
But low testing rates mean that many people with CKD remain undiagnosed. The National CKD Audit found that only half of the people with diabetes attended for their annual ACR test. Less than a third of people with hypertension were tested.
Regularly screening large groups of people has inherent challenges, and changing the behaviour of millions of people is difficult. Urine tests can be unpleasant, and traveling to the clinic is often inconvenient. But unless a solution is found for today’s low test adherence rates, the “missing million” may only discover they have CKD once it has progressed to its later stages. This is important because treatment for late stage CKD, particularly kidney transplant and dialysis, accounts for the majority of NHS expenditures on CKD.
Healthy.io’s CKD Early-Detection Service allows people to do their ACR urine test from the comfort of their homes, thus removing the barriers to testing and improving adherence rates. Rather than visit their GP, Healthy.io’s kit and smartphone app allow people to test and transmit their results within minutes, without leaving home. As part of the service, people also receive a friendly reminder to do the test if they have not yet done so.
The CKD Early-Detection Service’s ability to increase adherence was proven in a clinical evaluation in cooperation with Modality Partnership GP surgeries in Yorkshire and Humber. Our service was successful in raising adherence from 0% to 72% among the people who had not undertaken testing. 92% said they found the test easy or very easy to use. The vast majority preferred testing at home to testing at the clinic. In recognition of our achievement, we shared the HSJ Award for Primary Care Innovation of the Year with Modality Kidney Disease Partnership.
Hear what clinicians from Modality Partnership have to say about the evaluation:
Based on the results of the Modality evaluation, the York Health Economics Consortium (YHEC) designed a model projecting the public health and spending outcomes for the rollout of the CKD Early-Detection Service across England.
Each Clinical Commissioning Group rolling out the CKD Early-Detection Service can expect net cost savings starting from the first year.
Please visit us to learn more about our service and receive a detailed report on your CCG, including:
- A breakdown of the at-risk population
- Drill-down of our cost-savings model assumptions
- Sensitivity analysis of your CCG’s cost-savings potential
Request your report here