Significant Treatment Differences Found in Patients with Chronic Diseases


Varying treatments were seen among patients with diabetes, depression, and hypertension.

A recent study found that patients with common chronic diseases receive varying treatments.

The study, published in Proceedings of the National Academy of Sciences, included data from 250 million patient records in 4 countries. The researchers used the Observational Health Data Sciences and Informatics (OHDSI) program, which includes standardized data from more than 600 million patients.

"Modern randomized trials are currently carried out without a clear view of how current treatments are used," said study leader David Madigan, PhD. "In the future, before a randomized trial is started, an observational study like ours could be mandatory to determine the appropriate sample size and composition of control groups, among other factors."

In the current study, researchers found that a majority of patients with diabetes received metformin as a first-line treatment, but second-line treatments varied. They discovered quite a bit of variation in first-line treatment for patients with depression.

According to the study, 10% of patients with diabetes, 11% of patients with depression, and 24% of patients with hypertension had a unique treatment pathway that no one else shared.

"We found that while the world is moving towards more consistent therapy over time for the 3 diseases, there remain significant differences in how they are treated," concluded first author George Hripcsak, MD, MS. "This suggests that randomized clinical trials -- the gold standard in evaluating new therapies -- may not capture enough of the information needed to make their results more broadly generalizable to different populations."

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