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NCT07169422Recruiting

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

Community Pharmacist Prescription for Diabetic Kidney Disease (Rx4DKD): A Randomized Controlled Trial and Implementation Study

Source: ClinicalTrials.gov · Last updated 18 Mar 2026

Brief summary (registry, in English)

Type 2 diabetes is the leading cause of chronic kidney disease, which can result in serious complications such as kidney failure and heart disease. Although effective medications exist to slow the progression of kidney damage, they are often underused in primary care, particularly for individuals without a regular family doctor. In response to this gap, 46 community pharmacy-led primary care clinics were launched across Nova Scotia in 2023 to serve under-resourced areas. Pharmacists at these clinics can prescribe for many chronic conditions, but currently not for diabetic kidney disease. To address this, the research team collaborated with kidney, diabetes, and primary care experts, patient partners and regulatory bodies to develop and validate step-by-step prescribing guide (called algorithms) that support pharmacists in identifying and managing diabetic kidney disease. All medications included are approved, publicly funded in Nova Scotia, target people with earlier categories of diabetic kidney disease and includebuilt-in safety monitoring, nurse practitioner consultation or referral to a kidney doctor. This study will evaluate whether these algorithms improve kidney protective medication use which have shown to be beneficial for people with diabetes and kidney disease. The investigators will recruit 120 adults with type 2 diabetes from a provincial diabetes registry who do not have a primary care provider and screen them at pharmacy clinics for diabetic kidney disease. Those eligible and who wish to participate will be randomly assigned to either an intervention group receiving pharmacist-led care using the algorithms or a control group receiving usual care through walk-in, mobile, or virtual clinics. The investigators will measure how many patients begin and continue recommended medications, as well as any medication-related side effects or hospitalizations. Pharmacist participants will also complete a survey to identify what helps or hinders implementation in real-world practice. This research is relevant because it aims to expand access to kidney-protective treatments for people with diabetes, especially those with early forms of diabetic kidney disease who do not have regular access to primary care provider, ultimately improving long-term health outcomes.

Status (registry)
Recruiting
Study type
Interventional
Enrollment
120 (estimated)
First submitted
30 Aug 2025
Start date
1 Mar 2026
Primary completion date
1 Jan 2028
Lead sponsor
Nova Scotia Health Authority
NCT number
NCT07169422

What you commit to

  • Study type: Interventional
  • Planned participants: 120
  • From 1 Mar 2026 to the primary completion date, 1 Jan 2028
  • 1 site in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Already receiving all three medications: RASi, SGLT2i, and nsMRA .

Other illness

  • Type 1 diabetes
  • History of allergy or intolerance to either, renin angiotensin system inhibitor (RASi), SGLT2 inhibitor (SGLT2i) and nonsteroidal mineralocorticoid receptor antagonist (nsMRA).

Lab values

  • Exceed algorithm thresholds for potassium levels or eGFR less than 30 mL/min/1.73m²

Other

  • Hypotension
  • Limited life expectancy of less than 1 year
  • Followed by a subspecialty physician (e.g., nephrologist or endocrinologist)
  • Unable to give consent

Who the study is looking for

  • Adults ≥18 years with T2D and DKD (eGFR≥ 30-60 ml/min/1.73m2 and/or UACR≥3 mg/mmol)
  • Adults who do not have primary care provider,
  • Adults who are eligible for initiation of treatment with RASi, SGLT2i or nsMRA

Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (1)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Dalhousie University
Coordinator of this site? Confirm its status
HalifaxCanadaRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.