||Chronic kidney disease (CKD) carries a high burden for poor quality of life and high healthcare costs. Medication to reduce this burden is available but adequate monitoring of optimal use of such treatment is lacking. Quality indicators to evaluate medication treatment for CKD are needed. The aim of this project is to develop, validate and implement a comprehensive set of medication quality indicators for CKD patients. These indicators need to (1) assess medication treatment focusing on efficacy and safety aspects; (2) take into account differentiation for patient characteristics, such as age and disease severity; (3) be reliably measured using data collected from routine practice.|
The study consists of four phases recommended for the development and implementation of valid quality indicators. In phase 1, the indicators are developed and judged on reflecting evidence and guideline recommendations by an expert panel, including patient representatives. In phase 2, a cohort study is conducted to test the operational and construct validity using previously collected data from three large medical centers. In a subset of patients, the data from repeated visits will be used to assess continuity of medication treatment. In phase 3, a pilot study will be conducted to implement the indicators in 8 academic and 1 non-academic center. This will provide baseline data, which are used to identify priority areas for improvement. Also, a pilot is conducted to apply the indicators in a primary care cohort. In phase 4, effects of the implementation in the pilot centers are evaluated and a plan for widescale implementation and evaluation is made in cooperation with national organization responsible for measuring and improving quality of care.