Chronic kidney disease is much more common than is often thought, and its prevalence is growing rapidly both in Estonia and worldwide. The early stages of the disease are often asymptomatic, but over time, the filtering capacity of the kidneys deteriorates, which can slow down the excretion of drugs from the body and increase the risk of side effects.
Many drugs are partially excreted from the body through the kidneys. However, if the dose of a drug is not reduced accordingly in a patient with chronic kidney disease, the concentration of the drug in the body may increase, increasing the risk of side effects. At the same time, an unjustified reduction in dosage can have the opposite effect – the human body does not receive a sufficient amount of the active ingredient, which means that the treatment is ineffective. Therefore, accurate and timely adjustment of medication dosage is critical in cases of chronic kidney disease.
A smart assistant for healthcare professionals
To support healthcare professionals in making treatment decisions and to increase patient safety, the Health Insurance Fund has added a new drug database, Renbase © has been added to the decision support system used by healthcare professionals, which helps doctors assess which drugs and in what quantities are suitable for patients with chronic renal failure.
"The drug database provides doctors with advice on which drug to prescribe to a patient and in what quantity. This information is available in the Synbase portal, an information management decision support system created for healthcare professionals," said Gerda Joa, product manager for decision support systems at the Health Insurance Fund.
The new database offers:
- Accurate and up-to-date drug dosage recommendations based on the patient's kidney function (eGFR or glomerular filtration rate).
- Clearly differentiated information that helps avoid searching for information from different sources.
- Support for increasing medication safety by providing valuable information on medication selection and dosage.
"Studies show that severe renal impairment increases the risk of medication side effects by as much as 80% compared to normal kidney function. In contrast, nearly one-third of drug-related side effects in patients with renal failure are considered preventable, and healthcare professionals need tools that help them make faster, more accurate decisions that better take into account the patient's condition," added Joa.
Where can I find the database?
Starting in June, the new database will be available to healthcare professionals on the Synbase portal, which is part of the information management decision support system. This is an important step toward simplifying the daily work of healthcare professionals and improving the quality of care for patients with chronic kidney disease.
Starting in December 2023, Estonian healthcare professionals will have access to the health management desktop (TJT), a web-based environment that brings together various digital solutions to support patient care. An important part of the desktop is the medication regimen, which provides a comprehensive overview of medications and allows healthcare professionals to prescribe, change, cancel, and view a person's medication history. The new medication regimen solution is planned to be launched in the fall of 2025, also displaying the patient's latest eGFR result, which will allow Renbase© database classifiers and recommendations to be integrated into the medication regimen.