Future Health Today: A pragmatic 12-month cluster randomised controlled trial of quality improvement activities in general practice (appropriate investigation of people at increased risk of undiagnosed cancer and pharmacological therapies to reduce cardiovascular risk in people with chronic kidney disease) compared to active control

Project Summary

Future Health Today (FHT) is a technology platform that provides audit-and-recall, clinical decision support and monitoring of quality improvement activities. Two disease modules have been developed initially within the FHT platform:

1. Cancer module which searches the electronic medical record (EMR) for patients with abnormal test results (elevated PSA, platelets and anaemia) and additional clinical features placing them at risk of an undiagnosed cancer. The plan is to expand the diagnostic algorithms within the cancer module but these test results have been selected based on evidence of abnormalities which are often not followed-up, or evidence has changed recently (e.g. lowered threshold for abnormal PSA; new evidence about platelets as a predictor of cancer risk).
2. Chronic kidney disease (CKD) where markers of CKD are identified in the EMR and patients flagged to prompt guideline concordant care to reduce cardiovascular disease risk.

The FHT trial is a cluster randomised trial where the CKD arm acts as the control arm for the cancer module and vice versa. We will test the effect of this technology platform on the investigation and management of patients at increased risk of cancer or with CKD.