RecruitingNAINTERVENTIONAL

Improving Kidney Care in Type 2 Diabetes: A Study of Pharmacist Prescribing Versus Usual Care

This study aims to improve kidney care for people with type 2 diabetes, especially if they don't have a regular GP. Many effective kidney-protecting medicines exist but aren't always used. In Nova Scotia, pharmacists in new clinics can prescribe for many conditions, but not yet for diabetic kidney disease. Researchers have created simple guides (algorithms) to help these pharmacists identify and manage early kidney damage. We’re studying if pharmacists using these guides can help more people start and continue these important medicines compared to usual care. The goal is to see if this approach can lead to better kidney health outcomes for those at risk.

At a glance

Status

Recruiting

Phase

Sponsor

Nova Scotia Health Authority

Enrolment target

120

Start

01 Mar 2026

Estimated completion

01 Jul 2028

Diabetic Kidney Disease Type 2 Diabetes Chronic Kidney Disease

What is this study about?

If you have type 2 diabetes, you might also be at risk of developing kidney problems, sometimes called diabetic kidney disease. This can be serious and, if not managed, might lead to kidney failure or heart issues. There are good medicines available that can help slow down this damage and protect your kidneys, but sometimes people don't get them, especially if they don't have a regular family doctor.

This study looks at a new way to help people get these important medicines. In some areas, new clinics have opened where pharmacists can help with many health conditions. The researchers, working with kidney and diabetes experts, have created special step-by-step guides for these pharmacists. These guides help them know when and how to prescribe medicines to protect your kidneys, focusing on early stages of kidney damage. All the medicines considered are approved and publicly funded in Nova Scotia.

We want to find out if pharmacists using these guides can help more people with type 2 diabetes and early kidney damage start and stick with these helpful medications. We'll compare this to the usual care people get, for example, from walk-in clinics. Ultimately, the aim is to see if this new approach can make it easier for people to access kidney-protecting treatments, leading to better long-term health.

Key takeaways

Targets people with type 2 diabetes and early kidney damage.
Focuses on those who don't have a regular family doctor.
Uses pharmacists with special guides to prescribe kidney-protecting medicines.
Compares this modern approach to standard care.
Aims to improve access to important treatments and long-term kidney health.
Medicines included are approved and publicly funded.

Who may be eligible?

This study is looking for adults aged 18 or older who have type 2 diabetes and early signs of kidney damage. This means your kidney function (eGFR) should likely be between 30 and 60, or you have certain levels of protein in your urine (UACR).

It's important that you don't already have your own regular family doctor, as the study is specifically for people without this ongoing care. You also need to be a candidate for starting one of the specific kidney-protecting medications the study is looking at.

You wouldn't be able to join if you have very low blood pressure, type 1 diabetes, or a known allergy to the study medications. If you're already taking all the kidney-protecting medicines being studied, or if you have very advanced kidney disease, or are regularly seeing a kidney or diabetes specialist, you wouldn't be eligible. Also, if your potassium levels are too high or if you have other serious health problems that mean you might not live for at least another year, you can't take part.

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.

Are you 18 years old or older?
Do you have type 2 diabetes and early signs of kidney damage?
Do you *not* have a regular family doctor?
Are you able to start new kidney-protecting medicines?
Do you have any severe allergies to common heart/kidney medicines?
Are you currently seeing a kidney or diabetes specialist?

Answer every question to see your result.

What does participation involve?

If you decide to participate, you would first be screened at a pharmacy clinic to see if you meet the study requirements. If eligible and you agree to join, you'll be randomly assigned to one of two groups, like flipping a coin. One group will receive care where a pharmacist uses the special prescribing guides for your kidney condition. The other group will receive usual care, which might be through a walk-in, mobile, or online clinic.

The study will then track how many people in each group start and continue taking the recommended kidney-protecting medicines. Researchers will also keep an eye out for any side effects from the medicines or if anyone needs to go to hospital. The total duration of your participation isn't specified, but it involves monitoring your medication use and health over a period after starting care.

Potential risks and benefits

Taking part in this study could offer the benefit of potentially accessing kidney-protecting medications that you might not otherwise receive, which could improve your long-term kidney health. However, as with any medication, there's always a small risk of side effects. The study aims to monitor these carefully. You have the right to withdraw from the study at any time, for any reason, without it affecting your usual medical care.

Locations (1)

Dalhousie University
Verified postcode
Halifax, Canada· Recruiting

Common questions

What is diabetic kidney disease?

It's when your kidneys get damaged because of type 2 diabetes. It can lead to serious health problems if not looked after.

Why is this study important for people without a regular doctor?

It aims to find new ways for people without a regular GP to get important medicines that protect their kidneys, as they might miss out on this care otherwise.

What are 'pharmacist-led algorithms'?

These are special step-by-step guides that help pharmacists decide which kidney-protecting medicines to prescribe and how to manage them safely.

Will I get new medicine if I join this study?

If you're in the group receiving pharmacist-led care and meet the criteria, the pharmacist may prescribe kidney-protecting medication if appropriate for you.

What happens after the study ends?

The study's goal is to improve access to care. Results will help decide if this approach can be more widely used to benefit more people with type 2 diabetes and kidney disease.

How to find out more

Jo-Anne Wilson, BSc Pharm, ACPR, MEd, PharmD

jo-anne.wilson@dal.ca 9024886623 Official trial record

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