Improving Albuminuria Screening Compliance Using a Smartphone Urinalysis Kit

This proposal will examine the effect of mailed, smartphone urinalysis kits to improve albuminuria screening compliance and detection of albuminuria. The investigators will randomize 1,000 non-diabetic MyGeisinger portal users with hypertension and last clinic blood pressure >= 130/80 mmHg who have not received albuminuria screening to either: 1) control - usual care or 2) intervention - mailed urinalysis smartphone kit. All patients will first receive a reminder letter to have albuminuria screening completed at their clinic in coordination with the Geisinger Care Gap Team. Patients randomized to the intervention arm who do not complete this initial screening test will then be offered a mailed, smartphone urinalysis testing kit. Patients with 1+ or greater detected urine protein will be recommended to have urine albumin/creatinine ratio (ACR) testing to confirm albuminuria. Patients with ACR >= 30 mg/g will be referred to pharmacists for optimal treatment of albuminuria (ACE or ARB, statin, BP goal <130/90 mmHg).

Inclusion criteria

• 18 and older
• Hypertension
• Last outpatient BP ≥ 130/80 mmHg
• Active MyGeisinger users with a listed mobile phone number
• Has a Geisinger PCP and followed by the Care Gaps team
• No prior urine albuminuria test (urine dipstick, albumin/creatinine ratio, protein/creatinine ratio)

Exclusion criteria

• History of diabetes
• Receiving dialysis
• History of kidney transplant
• eGFR < 15 ml/min/1.73m2
• Principal investigator or PCP discretion (i.e. concerns about safety, compliance)