Menzies research fellow, Dr Paul Lawton was recently awarded an Early Career Fellowship as part of the National Health and Medical Research Council’s (NHMRC) yearly multi-million dollar funding round.
Paul’s fellowship provides support for his salary for the next four years. He shares his thoughts on the fellowship.
What is the title of your fellowship?
Chronic kidney disease in Indigenous Australians: using existing data to improve outcomes.
What major health issue does your research hope to address and how?
Indigenous Australians are at least seven times more likely to need dialysis or a kidney transplant to treat end-stage kidney disease than non-Indigenous Australians of the same age, worse in remote areas across northern and central Australia. So far, my research has shown that Indigenous Australians with kidney disease have poorer outcomes than comparable non-Indigenous Australian patients across the continuum, from early treatment, through to dialysis treatment, kidney transplant rates and survival. If we can improve the way health systems work for both individual Indigenous patients and the Indigenous population as a whole, we have a good chance of reducing substantially the numbers of those needing costly and distressing dialysis treatment, as well as improving the lives and lifespan of those who do.
What is the most exciting aspect of your funding win?
What’s most exciting is that it gives me a chance to make a difference across the health system. As a doctor one can make a difference to an individual, and it’s great to see that immediate result. But as one doctor I can only deal with so many patients in a day, in one place: through my research I aim to improve care for thousands, if not tens of thousands, across the country.
What are the proposed details of your research methodology (sample numbers, sites etc)?
Most of my research relies on using existing data collected routinely in clinics, in the care of patients with earlier stage chronic kidney disease or end-stage kidney disease. Newer data handling and statistical techniques now allow us to more carefully measure variations in processes and outcomes of care between clinics (so-called “centre-effects”). I’ll be examining the care of around 6 000 patients with earlier stage chronic kidney disease in Northern Territory remote communities, and over 40 000 patients nationally with end-stage kidney disease receiving renal replacement therapy (around 10% of whom are Indigenous).
What are the broader health implications of your fellowship?
It will lead to paradigm-shifting output in Indigenous kidney disease research in Australia away from the causes of disease and towards more effective real-world care for those with kidney disease. They will lead to policy and clinical practice change through a combination of (i) highlighting specific areas for improvement in partnership with clinicians and policy-makers and (ii) further interventional research that will be informed by results from these projects. The methods developed and extended in this research will be useful in other, non-Indigenous kidney disease settings nationally and overseas, as well as with other non-communicable chronic diseases such as diabetes and heart disease.