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Diabetes Interdisciplinary Research on Epidemiology, Costs, and Treatment (DIRECT) to Optimize Patient Outcomes and Inform Policy

Principal Investigator: Dr. Larry Lynd (Co-Is: Drs. Aslam Anis and Mark Harrison)

Status: Ongoing

Diabetes places a significant burden on patients and the health care system. This chronic condition, characterized by excess blood glucose levels (hyperglycemia), affects over 2.5 million Canadians and around 400,000 British Columbians.

90 per cent of people with diabetes have Type 2 diabetes, which requires lifestyle/self-management treatment and antihyperglycemic drugs. However, evidence of the optimal sequencing of antihyperglycemic drug treatments based  on their relative value is lacking. Furthermore, new antihyperglycemic drug therapies are continually coming to market, thus necessitating the ongoing real-world evaluation of costs and outcomes of alternative treatment strategies.

Decision makers lack the necessary evidence of the short- to medium-term costs and outcomes related to diabetes treatments, both of which are primarily driven by side-effects and long-term complications of diabetes. Current disease models often make assumptions, and rely on historical data, thus lack contemporary and context-specific evidence.

Dr. Lynd and his colleagues will use a population-based cohort of diabetes patients in order to evaluate the real-world costs and outcomes associated with diabetes between 1996 and 2014. They will determine diabetes therapy treatment patterns over time, and evaluate factors associated with varying treatment patterns. They will identify care gaps and what causes them, calculate the overall economic burden of diabetes in British Columbia, and finally, identify strategies to improve patient outcomes and reduce the economic burden of diabetes.

This will be the first truly population-based study in diabetes to link drug and health care resource utilization data with perinatal and outpatient laboratory data.

The project is a CHÉOS collaboration with Merck, PHEMI, the Faculty of Pharmaceutical Sciences, and the Personalized Medicine Initiative.

Health research in the heart of Vancouver