Optimizing Medication Use and Treatment Decision-Making for people with Chronic Kidney Disease

One in ten Swedes suffer from Chronic Kidney Disease (CKD), a high-risk condition in need of tailored pharmacological therapy.

Ensuring adherence to guideline-recommended care and evaluation of medication’s risk-benefit is critical in this population prone to adverse drug events.

However, there is limited evidence, due to disease under-recognition, and the need to rely on laboratory tests to evaluate kidney function, monitoring practices and adverse events.This project aims to improve the care of patients with or at risk for CKD.

With previous support from Vetenskapsrådet, we established a dedicated pharmacoepidemiology group and a unique recurrent database enriched with laboratory measurements from the totality of the population of Stockholm to identify best clinical practices for effective and safe use of medications across the spectrum of kidney dysfunction.We now want to further our work byIdentifying gaps in care among patients with or at risk for CKD, focusing on guideline-recommended use, dosing and monitoring.Addressing risks vs benefits of medications by stages of CKD severity.Applying novel methods to routine care data to detect unknown signals of harm and identify patients most likely to benefit from underutilized treatments.Bringing action to the point of patient care, by piloting electronic clinical decision support tools to optimize care and medical treatments and for these patients.

Results from this project will thus direct applicability in Swedish healthcare.