No abstract available

No abstract available

Background: The effectiveness of erythropoiesis-stimulating agents, which are the main stay of managing anaemia of chronic kidney disease (CKD), is largely dependent on adequate body iron stores. Levels of serum ferritin concentration and transferrin saturation, two surrogate markers of iron stores, are used to guide iron replacement therapy. Most First Nation Australians of the Northern Territory with end-stage kidney disease (ESKD) have ferritin levels higher than current guideline recommendations for iron therapy. There is no clear evidence to guide safe and effective treatment with iron in these patients. Aim: To assess the impact of intravenous iron treatment on all-cause death and hospitalisation with a principal diagnosis of all-cause infection in First Nations patients on haemodialysis with anaemia, high ferritin levels and low transferrin saturation. Methods: Using a prospective open-label blinded endpoint randomised controlled trial design, we aim to enrol 576 participants on maintenance haemodialysis with high ferritin (> 700 μg/L and ≤ 2000 μg/L) and low transferrin saturation (< 40%), from renal units across the Northern Territory, to receive intravenous iron polymaltose 400 mg monthly (200 mg during 2 consecutive haemodialysis sessions) (Arm A) or no IV iron treatment (standard treatment) (Arm B). Rescue therapy will be administered when the ferritin levels fall below 700μg/L or when clinically indicated. Conclusion: The INFERR clinical trial will address significant uncertainty regarding the lack of evidence about the safety and efficacy of iron therapy in First Nations Australians with ESKD, who have hyperferritinaemia and evidence of iron deficiency.

Background: In the Northern Territory, integrated healthcare is challenged by a highly mobile population, siloed health services and lack of a unique identifier. Territory Kidney Care (TKC) is a digital clinical decision support tool that was developed to close this information gap. As patients often have multiple unconnected health records, data linkage is central to the functionality of TKC. Aims: To validate the automatic linkage protocol in TKC, identify false negatives and co-design feedback mechanisms to improve the quality and completeness of patient information. Methods: We examined audit reports to identify potential false negatives where patient records remain unlinked due to mismatch in name, date of birth (DoB), or health record number (HRN). This was checked by searching for corroborating information in source systems (corrected HRN or DoB) and establishing a feedback mechanism with health services. Results: Of the 72159 TKC patients, 38096 (52.8%) had records from multiple systems consisting of 14,703 (20.4%), 18,104 (25.1%) and 5,289 (7.3%) from 2, 3 and ≥4 health systems respectively. 750 (2.0%) patients had multiple unlinked records requiring investigation. We co-designed an efficient and secure process to communicate demographic advice between services with 429 patients subsequently linked, 6 records adjudged never to be linked,144 patient records updated with a universal identifier and 174 awaiting additional information. Conclusion: The TKC data linkage protocol improves the quality and completeness of patient information by enabling almost all available data to be linked, which generates a more comprehensive picture of the patient journey to inform clinical decision making.

PS5 Standard for Pharmacy Based Immunisation Programs

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