Prescribing Anticoagulants in Chronic Kidney disease (PACK) study

  • Research type

    Research Study

  • Full title

    Anticoagulation in advanced Chronic Kidney Disease- Exploring and Guiding Current Prescribing Practice in the UK

  • IRAS ID

    281018

  • Contact name

    Kathrine Parker

  • Contact email

    kathrine.parker@mft.nhs.uk

  • Sponsor organisation

    University of Manchester

  • Duration of Study in the UK

    3 years, 0 months, 29 days

  • Research summary

    Blood thinning medications- known as anticoagulants- are classified as high-risk because under-dosed patients are at risk of blood clots and over-dosed patients are at risk of bleeding, often with fatal consequences. Patients prescribed anticoagulants with pre-existing chronic kidney disease (CKD) are at higher risk of experiencing both clotting and bleeding episodes than those with normal kidney function. This makes anticoagulant use in this group of patients more complex.
    Unfortunately, there are still large gaps in what is known about the use of anticoagulants in CKD. Making treatment decisions challenging for patients and clinicians.
    This study aims to identify differences in prescribing decisions and reasons for these differences by undertaking a nationwide survey of current practice with follow-up semi-structured interviews with a sample of clinical staff. Focus groups with CKD patients who had been or are currently taking anticoagulants will explore their views and concerns regarding anticoagulation. Patients will be recruited via adverts in kidney patient magazines and on social media. These focus groups will be held in different locations dependant on patient geography.
    Data from CKD patients taking anticoagulants for atrial fibrillation, a fast heart rate, will be used to develop a risk score to help decide which patients will benefit from the use of anticoagulants. De-identified patients will be sent information about the study via their GP and postal consent will be undertaken to access their data held by the GP.
    All these parts of the study will then be used to help form the basis of a guideline that will be agreed upon with a group of experts in this field and patients. This document should support both clinicians and patients when making difficult decisions around anticoagulant treatment.

    The study is funded by the National Institute for Healthcare Research (NIHR).

  • REC name

    North West - Greater Manchester Central Research Ethics Committee

  • REC reference

    21/NW/0180

  • Date of REC Opinion

    13 Jul 2021

  • REC opinion

    Further Information Favourable Opinion