World-first guideline transforming patient treatment and care

Overview

eviQ provides cancer health professionals with evidence-based, consensus-driven, best-practice cancer treatment protocols and information at the point of care. Developed by multidisciplinary specialists for the Australian clinical context, resources aim to improve patient outcomes and reduce treatment variation.

In the past, anticancer drug dosing recommendations in kidney dysfunction had inconsistencies, a lack of definitive guidance, large variations and limited evidence on older drugs. To address these gaps, the eviQ team set out to develop a supportive decision-making tool, providing an accepted practical, transparent and standardised approach for the management of anticancer drug dosing in kidney dysfunction, based on current evidence and clinical consensus.

This world-first International Consensus Guideline for Anticancer Drug Dosing in Kidney Dysfunction (ADDIKD) was published in 2022 and includes recommendations for 59 anti-cancer drugs.

Evaluation methodology

A mixed methods evaluation was undertaken on the ADDIKD Consensus Guideline, focusing on the guideline development process, the impact of stakeholder engagement, and early outcomes of guideline implementation.

Key findings

Harnessing their trusted reputation in cancer treatment information and education, eviQ successfully engaged an international working group to develop and gain acceptance of the Consensus Guideline.

This was enabled through:

• Appointment of a designated internal program team and lead, who facilitated communication to stakeholders and experts, including the working group.
• Leadership of an experienced working group chair.
• A virtual guideline methodology framework, enabling both international and professional engagement.

Recognising the significant impact the ADDIKD Consensus Guideline would have for both clinicians and cancer services across Australia, eviQ put measures in place to ensure the best chance of implementation success to transform patient treatment and care.

 

“I think the impact of this guideline will be significant in terms of almost immediate change in clinical practice but hopefully the guideline helps form part of a broader discussion around estimation of kidney function more generally and ensuring we’re taking that step back to consider not just the level of kidney dysfunction but the patient and their clinical status when we are making drug dosing decisions.”

- Ms Carla Scuderi, ADDIKD Expert Contributor

A comprehensive engagement strategy was developed and used to support eviQ clinical users and electronic oncology information systems (OIS) vendors. This included a pre-implementation survey, regular communication, and training opportunities. Engagement also included tailored communications about the changes and timeframes.   

The ADDIKD Consensus Guideline is reaching a wide audience in Australia and overseas.

The Consensus Guideline has received comprehensive international endorsement from multiple oncology, renal and pharmacy societies. Kidney Disease: Improving Global Outcomes (KDIGO), Advanced Pharmacy Australia (AdPha) and the American Society of Onco-Nephrology have included the consensus statement’s recommendations in their position statements and guidance.

The ADDIKD Consensus Guideline web page had:

• Over 33,400 views
• Over 12,100 visitors
• Been accessed by users from Australia, USA, Spain, Portugal, Brazil and New Zealand.

(October 2022 to March 2025)  

“The highlight for me in developing this guideline was the opportunity to work with multidisciplinary specialists across all areas of medicine, not just cancer medicine, but also renal medicine, and to see the amazing input that our renal colleagues had in the development of this guideline.”

- Prof. Robyn Ward, Chair of the eviQ Working Group

Opportunities

eviQ will continue to engage with stakeholders to ensure long term, sustainable practice change. There is an opportunity to explore learnings from the implementation for future optimisations at a local level and for future guideline development.

What is next?

The development and widespread adoption of the ADDIKD Consensus Guideline recommendations through eviQ treatment protocols have standardised anticancer drug dosing in patients with kidney dysfunction. By using globally accepted kidney function calculations, these guidelines reduce significant variation in dose adjustment practices. This promotes high-quality, evidence-based care and strengthens eviQ’s position as a leader in cancer information and education.

In a short time, the ADDIKD Consensus Guideline has driven notable changes in clinical practice. This success is attributed to strong project management, a dedicated project team, and a well-executed communication, engagement, and change management strategy. A proactive approach to identifying and addressing implementation barriers before publication played a key role in its effective uptake.

 

“It is an incredible tool to promote in my view the research and to try to help people working together across the world and across specialties and disciplines because we need pharmacists to work with haematologists and oncologists and nephrologists in order to collectively improve the quality of care in terms of treatment in cancer patients.”

- Prof. Corinne Isnard-Bagnis, ADDIKD Working Group Member