Electronic Nudge Letters Fail to Boost Guideline-Adherent Treatment in CKD Patients
A recent study finds that electronic nudge letters do not increase guideline-based medical therapy uptake among CKD patients, highlighting challenges in digital health interventions.
Recent research has shown that sending electronic nudge letters to patients with chronic kidney disease (CKD) or their healthcare providers does not significantly increase the adoption of guideline-recommended medical therapies. A large nationwide study, published in the journal Circulation on June 7, 2025, evaluated whether these digital prompts could improve treatment rates. The trial included over 23,000 patients with CKD and involved randomizing them to receive either an electronic nudge letter or usual care, along with their general practices being similarly assigned to receive informational letters or not.
The primary medications targeted were renin-angiotensin system inhibitors (RASi) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), known for their benefits in CKD management. The results demonstrated that approximately 65% of patients, regardless of whether they received a nudge, filled prescriptions for these medications during the follow-up period. Similarly, no significant difference was observed in prescription rates among practices that received electronic informational letters versus those that did not. In essence, neither the patient-directed nor the provider-directed electronic interventions led to improved guideline-adherent medication use.
The researchers concluded that large-scale digital nudges, at least as implemented in this trial, do not enhance the adoption of recommended therapies in CKD management. This finding underscores the challenge of effecting behavioral change through electronic prompts and provides valuable insights for future efforts to improve medical guideline adherence. The study emphasizes the importance of exploring alternative strategies to increase the implementation of proven treatments for CKD.
For more details, see the full study in Circulation: DOI: 10.1161/CIRCULATIONAHA.125.075403. Source: https://medicalxpress.com/news/2025-06-electronic-nudge-letters-guideline-medical.html
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