Drug utilisation research; pharmacoepidemiology; clinical outcome research; secondary database analysis

The new British guidelines for treating type 2 diabetes have recommended the newly introduced oral antidiabetic agents (particularly gliptins and glitazones) as an option for second line therapy added to metformin or first line if metformin was not suitable. Despite their demonstrated clinical efficacy and safety evidence from clinical trials, findings from observational studies around their clinical effectiveness and safety in real world are controversial; especially there are safety concerns around their CV outcomes. Furthermore, there is little evidence on the cost-effectiveness of non-metformin based dual combination and the optimal agent for triple combination. This is an important area to explore giving the growing increase in the incidence of diabetes in younger population and the natural decline in diabetes control over time, which both results in an increase need for triple non-insulin based combination therapy

Therefore, this research project aims to investigate the utilisation/prescribing patterns, adherence, clinical effectiveness, safety and costs of these new agents, alone or in combination, on diabetic control and long-term cardiovascular morbidity/mortality.

The project involves applying various epidemiological research study designs and methodologies using data extracted from linked electronic health records in Scotland.

National Institute for Health and Care Excellence. Type 2 diabetes in adults: management (NG28). 2015. Available at:https://www.nice.org.uk/guidance/ng28/resources/type-2-diabetes-in-adults-management-1837338615493. Accessed 28th November 2016