RecruitingPhase IVInterventional

Digital multi-component intervention to improve the care of older people living with diabetes and chronic kidney disease

Living with diabetes can sometimes lead to kidney problems, especially for older people. This study, called IMPROVE DKD, wants to see if a simple computer reminder system can help family doctors (GPs) provide the best possible care for these patients. The reminders would pop up during appointments to help GPs follow important guidelines on things like blood pressure control and specific medications. Researchers believe this could help slow down kidney damage, reduce serious health risks like heart attacks, and ultimately improve the health and well-being of many older people with diabetic kidney disease across the UK. It could also make healthcare more efficient.

At a glance

Status

Recruiting

Phase

Phase IV

Sponsor

University of Birmingham

Enrolment target

1,500

Start

15 Nov 2025

Estimated completion

15 Nov 2027

Diabetic kidney disease (DKD)

What is this study about?

Diabetes can sometimes affect the kidneys, a condition called diabetic kidney disease (DKD). This is quite common, especially in older adults. If kidney problems get worse, people might eventually need dialysis or a kidney transplant. They also face a higher risk of heart problems and strokes. While there's no cure for DKD, we know that looking after yourself with a healthy lifestyle, carefully controlling blood pressure and diabetes, and sometimes taking specific medicines can help slow down the disease.

However, research suggests that family doctors (GPs) don't always get to follow all the recommended guidelines for DKD care. This can be due to many reasons, including how busy GP practices are. This study is looking into whether a digital tool – basically, a computer prompt – can help support GPs in following these important guidelines. The hope is that by making it easier for doctors to stick to 'best practice' care, we can help people with DKD keep their kidneys healthier for longer.

The study will first develop this computer prompt with input from patients, doctors, and computer experts. Then, it will be tested in many GP practices across England. The main goal is to see if these prompts really do help GPs and if they can make a difference in slowing down kidney damage in older patients with DKD. If successful, this simple change could improve care for a large number of people, potentially reduce serious health issues, and even save money for the NHS.

Key takeaways

This study evaluates a digital tool to support GPs in treating diabetic kidney disease.
It aims to improve care for older people with kidney problems caused by type 2 diabetes.
The tool provides computer reminders to help GPs follow treatment guidelines.
No new medicines or extra patient appointments are involved for most participants.
It could help slow down kidney damage and improve patient health outcomes.
The study runs from September 2024 to August 2028 across 60 GP practices in England.

Who may be eligible?

This study is mainly for GP practices in England that use specific computer systems and share their patient data for research. These practices will be invited to participate.

Within these practices, the study will focus on patients who are aged between 18 and 80 years old, have type 2 diabetes, and have a certain level of kidney problem (known as 'CKD stage 3'). The study will pay special attention to patients aged 60 and over.

You would not be able to be included if you have type 1 diabetes, other specific kidney conditions, are on certain medications that affect your immune system, are on dialysis or have had a kidney transplant, have active cancer, are receiving end-of-life care, have dementia, or have previously asked for your data not to be used for research.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Do you have type 2 diabetes?
Are you between 18 and 80 years old?
Have you been told you have moderate kidney problems (CKD stage 3)?
Are you not receiving end-of-life care or have dementia?
Are you not currently on dialysis or had a kidney transplant?
Have you not previously asked for your health data not to be used for research (opted out of CPRD)?

Answer every question to see your result.

What does participation involve?

This study involves two main stages. In the first stage, researchers will work with computer experts, patients, and GP staff to create a computer reminder system. This system will pop up on GP computers during appointments to help doctors follow five key guidelines for kidney care, including controlling blood pressure and sugar levels, and suggesting certain medications. Patients will also receive lifestyle advice, either as a video or a leaflet.

In the second stage, 60 GP practices will take part. Some practices will use the new computer reminder system, and others will continue with their usual care (without the reminders). For patients, there will be very few, if any, extra visits. The study will gather information about kidney function and other health details from your routine GP records for two years. This helps compare how well patients in the different groups are doing. You would continue to receive your usual medical care from your GP.

Potential risks and benefits

There are potential benefits to this study, both for patients and the NHS. If this digital tool works well, it could lead to better and more consistent care for people with diabetic kidney disease everywhere, potentially slowing down kidney damage and reducing the risk of heart problems. This could also help the NHS by reducing treatment costs. For you as a patient, there are no additional risks, as you will continue to receive your usual medical care from your GP. You might even benefit directly if your GP practice is using the new digital tool. Remember, you always have the right to withdraw your consent for your data to be used in the study at any time, without it affecting your medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Primary care practices
Unverified
United Kingdom

Common questions

What is diabetic kidney disease (DKD)?

It's when your kidneys are damaged because of long-term diabetes. It can sometimes get worse over time.

What is the main goal of this study?

To see if computer reminders can help GPs follow guidelines better, potentially slowing down kidney damage in older patients with DKD.

Will I have to take new medicines?

This study doesn't involve new medicines. It looks at how GPs use existing guidelines and treatments.

Will I have more appointments?

For patients, there will be either no or very few extra visits, as information is collected from your routine GP records.

Who is paying for this research?

The National Institute for Health and Care Research (NIHR) in the UK is funding this study.

How to find out more

Raquel Fernandez del Rio

improvedkd@trials.bham.ac.uk +44 (0)121 414 3344 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.