Before doctors can prescribe medicines, clinical trials must show that they are safe and that they work. However, trials last for a short period of time, and not everyone can take part in them. Thus, we still have unanswered questions about how safe and effective these medications are in real life.
This research will examine conventional and newer medications used in rheumatology. This will include medicines for inflammatory diseases, like rheumatoid arthritis and lupus. These diseases occur when the body's immune system overreacts, causing swelling and pain. It will also include medicines used in diseases that affect the bones, like osteoporosis and rickets. We will study the benefits and side effects of medications over a longer time period compared to trials and consider groups often excluded from trials, such as those with more medical conditions. We will also examine differences in clinical factors and patient characteristics to see if these can help with treatment decisions. This is important because in many cases we cannot predict which medication will work for a patient before starting the treatment.
We will use Scotland’s excellent healthcare information system to create the necessary linked dataset. It will have data on people seen in rheumatology clinics across Scotland. It will combine data on deaths, hospital admissions, cancer registrations, lab test results and medical imaging with data on prescriptions. Public Health Scotland will link the datasets and remove all personal identifiers. We will then analyse the data inside the National Safe Haven, which is a safe computing environment owned by Public Health Scotland. We will first process the data to clean it and make it ready for research. Then, we will use statistical methods to look at differences in outcomes by drug and clinical factors.
This research can address safety concerns for newer medications. It can reduce the number of people getting harmful side effects. It can increase the number of people eligible for certain medications. It can inform treatment strategies and help identify who might end-up with substantial disability long-term.
