Designing and validating a clinical decision support algorithm for diabetic nephroprotection in older patients.

Background: Older patients with diabetic kidney disease (DKD) often do not receive optimal pharmacological treatment. Current clinical practice guidelines (CPGs) do not incorporate the concept of personalised care. Clinical decision support (CDS) algorithms that consider both evidence and personalised care to improve patient outcomes can improve the care of older adults.

Exploring key components and factors that influence the use of clinical decision- support tools for prescribing to older patients with kidney disease: the perspective of healthcare providers.

Background: Clinical decision-support (CDS) tools are systems that provide healthcare providers (HCPs) with recommendations based on knowledge and patient-specific factors to facilitate informed decisions.

Objectives: To identify the key components of a CDS tool that are most important to HCPs in caring for older adults with kidney disease, and to understand the facilitators and barriers toward using CDS tools in daily clinical practice.

Methods: Design: A cross-sectional survey of Canadian HCPs was undertaken.

Is health-related quality of life trajectory associated with dialysis modality choice in advanced chronic kidney disease?

Background: Patients with advanced chronic kidney disease have lower health-related quality of life (HRQOL) than the general population. There is uncertainty regarding patterns of HRQOL changes before dialysis initiation. This study aimed to characterise HRQOL trajectory and assess its potential association with intended dialysis modality.

Effect of isotretinoin on CYP2D6 and CYP3A activity in patients with severe acne.

Aims: Previously, retinoids have decreased CYP2D6 mRNA expression in vitro and induced CYP3A4 in vitro and in vivo. This study aimed to determine whether isotretinoin administration changes CYP2D6 and CYP3A activities in patients with severe acne.

Methods: Thirty-three patients (22 females and 11 males, 23.

Older age, kidney concordant diseases and the dilemma of adherence to guidelines: A narrative review.

Evidence-based medicine is pivotal to contemporary clinical practice, and the excellence of a healthcare institution is measured by the adherence of its clinical staff to the clinical practice guidelines (CPGs) among other standards and policies. Following the recommendations of CPGs in older adults poses different challenges to prescribers. In this narrative review we explore research studies that assessed clinicians' adherence to CPGs when prescribing to older adults with chronic kidney disease and its concordant disorders, and to discuss the potential barriers and facilitators to better adherence to CPGs.