Using electronic health records to understand the best available treatment for patients, from a range of possible options, is more efficient and less costly for taxpayers than the existing clinical trial process, new research shows.
The study, which is published in the journal Health Technology Assessment, looked at the use of statins in 300 people with high risk of cardiovascular disease by tracking their electronic records. It also examined the use of antibiotics in participants with chronic obstructive pulmonary disease (COPD).
Currently, when researchers want to investigate whether one treatment is better than another, they need to organise lengthy and expensive clinical trials that require “heavy form-filling” by patients and GPs, additional staff resource and regular attendance at appointments, the authors note. Such trials can also create artificial test environments that do not represent the reality of patient behaviour in everyday life.
Instead, the researchers installed a new computer programme in 23 GP surgeries across England and Scotland. This was able to confidentially identify which patients were eligible to take part and allowed doctors to sign up relevant participants at the click of a button, saving time and public money, they say.
They then used the patients’ electronic health records, as recorded in the Clinical Practice Research Datalink (CPRD) and updated as part of their regular medical appointments, to monitor the impact of the treatments they had been prescribed.
These records enable researchers to understand health patterns in relation to specific medications with potentially much larger and more diverse populations, and to understand which treatment offers the best results. The work is conducted with minimal impact on the lives of patients who, after offering their consent, are not required to have any active involvement.
Following participation in the study, 26 out of 27 interviewed GPs expressed strong support for using patients’ electronic records to support clinical trials. 10 patients were also interviewed, who all agreed that discussion of their involvement in the trial as part of a routine health appointment was a wholly acceptable practice.
The study was led by Professor Tjeerd van Staa of The University of Manchester’s Health eResearch Centre, in collaboration with researchers from the London School of Hygiene and Tropical Medicine and the Universities of York, Liverpool and Brighton and King’s College, with funding from the National Institute for Health Research (NIHR) and the Wellcome Trust.