[Copenhagen, ISPOR Europe, November 13th 2023]
Paris and London, November 7, 2023
The Health Improvement Network (THIN®), a Cegedim database, is an unobtrusive medical data collection scheme that contains anonymized health records of over 17 million patients in the UK. It is one of the most extensive primary care databases in the world, providing valuable insight into the patterns of diagnosis, treatment, and outcomes of various medical conditions.
Cegedim Health Data’s THIN® Database and Outcomes Manager solution to provide the foundation for the implementation and evaluation of a novel ‘dAta-DrIven rANdomised clinical Trial platform’ in primary care (RADIANT*)
For decades, medical improvements and better living conditions have resulted in ever increasing life expectancy. Yet according to the Organisation Economic Cooperation and Development 2021 Health Indicators, life expectancy in Britain fell from 81.4 years in 2019 to 80.4 years in 2020, as a result of the high number of deaths caused by coronavirus. It is even more startling to consider therefore, that globally, men die on average five years earlier than women, and for reasons that are largely preventable.
Everyone needs some cholesterol, but according to Heart UK over half of UK adults have raised cholesterol, which can lead to heart disease. For many individuals, positive lifestyle changes can make a difference and keep cholesterol levels healthy. But there are other factors that can affect cholesterol levels – including genetics and menopause – and, left unchecked high cholesterol (hypercholesterolemia) may lead to atherosclerosis (the deposition of cholesterol in the walls of arteries) which can reduce the flow of blood to the heart and brain, leading to heart diseases and stroke.
Globally, nations have adopted preventative strategies to mitigate the risk of high cholesterol; in the UK alone over eight million people are routinely prescribed cholesterol lowering drugs (Statins). Given the significant population groups both with high cholesterol and taking prescribed medication it is therefore vital not only for individuals to understand – and check – their cholesterol levels but also for clinicians to understand and track the efficacy of both lifestyle change and medication.
However, according to analysis of The Health Improvement Network (THIN®), a Cegedim database, analysis of the percentage of cholesterol blood tests out of contacts in THIN® by blood test and year between 2017 and 2021 confirms that tests plummeted in March 2020 and have yet to recover to pre-COVID 19 levels.
Which is one of the reasons why this October, during National Cholesterol Month, everyone is being advised to Talk about Cholesterol – and get a simple cholesterol test.
2021 marks the 10th anniversary of the annual ‘Stoptober’ smoking cessation campaign which has, to date, encouraged two million people in the UK to attempt to stop smoking. There are many incentives for eliminating cigarettes - from health to wealth; but in the wake of a global respiratory pandemic, the known respiratory disease risks associated with smoking tobacco have reinforced many individuals’ desires to finally give up smoking.
Around 15 million adults in the UK are estimated to have high blood pressure, but more than one third of those cases go undetected. With pressures on GPs mounting, NHS England has recently announced the role of pharmacies in checking blood pressure. If the goal of checking the blood pressure of 2.5 million more people is achieved, NHS England suggests it could prevent 3,700 strokes and 2,500 heart attacks, saving 2,000 lives, in the next five years.
Individuals are also being encouraged to monitor their own blood pressure readings during Blood Pressure Awareness week. This year’s ‘Know your Numbers!’ week – running from 6th to 12th September – is raising awareness of high blood pressure, encouraging all UK adults to get a blood pressure check.
Screening programmes have become a core strand within NHS disease prevention strategies over recent years – with cervical screening one of the most far reaching. Every year five million women and people with a cervix are invited for screening – and the screening process can prevent up to 75% of instances of cervical cancer, saving 5,000 deaths per year.
However, in common with many routine screening activities, the numbers invited to and attending cervical screening during 2020 dropped. Analysis of The Health Improvement Network (THIN®) a Cegedim database, revealed the percentage of cervical cancer smear tests out of contacts were significantly down in 2020 compared to the average between 2017 and 2019. The numbers plummeted in March 2020 when all non-urgent activity was suspended and very few tests occurred in April or May 2020. However, a year on and attendance for cervical cancer screening has now increased and is now back to pre-pandemic levels.
Every individual has had a different lock-down experience – and for many there has been a notable impact on their mental health. Whether it has been loneliness and isolation, insecurities and fears regarding the financial future, or a lack of familiar routine, lives have been turned upside down. Even as the vaccination programme continues at pace, many questions, concerns and anxieties remain – and, it is becoming clear, there is a very significant section of the male population that is failing to call for help.
Hand sanitising has taken centre stage over the past year as a key strategy in the fight against COVID-19 transmission. But as any healthcare professional knows, hand hygiene is vitally important every day – especially in the fight against sepsis.
2020 has had a devastating effect on many individual’s physical and mental well-being: new research from the Mental Health Foundation states that 74% of UK adults in the past year have felt overwhelmed or unable to cope as a result of stress.
According to the Stress Management Society, stress is one of the great public health challenges of our time – yet still isn’t being taken as seriously as physical health concerns. Stress is a significant factor in mental health problems including anxiety and depression. It is also linked to physical health problems like heart disease, problems with our immune system, insomnia and digestive problems.
Why real-world data matters to patients
Healthcare systems globally are increasingly recognising the value of healthcare data. From developing improved care pathways to driving cost savings through data analytics, arguably the true value of healthcare data lies in patient outcomes.
Good data can power better, safer and more effective models of care for patients. As technology unlocks new data sets and more sophisticated tools of analysis, our ability to harness information will be key to driving better health outcomes and more sustainable models of care.
COVID-19 has hit every part of health and care provision. From patients avoiding contacting GPs leading to missed or delayed diagnosis to delays in cancer treatments and knee replacements, millions of patients have been affected. As the vaccination programme continues to roll out and a degree of normality returns, these patients will require care – many urgently.
But how are Clinicians to prioritise? It is not possible to open the doors to all patients at once – in primary or secondary care. Whether it is patients demanding face to face GP visits or the backlog of outpatient visits that need to be re-organised, how can health and care providers allocate resources in the most effective way to support priority patient needs?
This World Health Day on 7th April, the World Health Organization (WHO) is embarking on a new campaign to build a fairer, healthier world to provide consistent access to health services. A key strand of the campaign surrounds data collection, with WHO confirming the importance of timely and reliable health data in assessing inequities across population subgroups and taking the required actions.
Three million people in the UK have chronic kidney disease (CKD) – and too often it is fatal. In 2019, five people died every week waiting for a kidney transplant. Sadly, the global pandemic has made the situation worse. Not only are people with CKD vulnerable and face a higher risk of becoming seriously ill or dying but the virus also affects kidney health: up to a quarter of people who have COVID-19 and receive ventilation in intensive care end up with severe acute kidney injury (AKI) and need dialysis.
Furthermore, the triggers for CKD, including weight gain, lack of exercise, diabetes and hypertension, have increased during the pandemic – and the impact is clear. According to analysis of The Health Improvement Network (THIN®), a Cegedim database, while diagnosis of CKD dropped during lockdown, by the end of December 2020 CKD diagnoses actually surpassed baseline measures – something not seen in other disease areas, which are still below baseline.
Which is why the focus for this year’s World Kidney Day - The Big Topic everyone is ignoring – is spot on.
Anyone involved in the analysis of health data knows the importance of telling the story – finding insights that can be easily consumed and, hopefully, support real change.
As part of its drive to promote innovative and effective use of Business Intelligence within the healthcare industry, the BHBIA’s Best of Business Intelligence (BOBI) Awards recognise excellence across the healthcare business intelligence spectrum. The Analyst of the Year award, sponsored by Cegedim Health Data, was won by Genevieve Hall, Director at Insight DoJo, for her analysis of the prescription of opioid analgesics across CCGs in England.
A year is a very long time in the life of a child. While adults are railing against the constraints of the pandemic, for children the isolation and lack of familiar structure of the past 12 months represents as much as a fifth of their lives. It has become a very unwelcome norm.
Cancer services have come under unprecedented pressure during the COVID-19 crisis – with recent analysis by the MacMillan Cancer Trust suggesting tens of thousands of people across the UK are missing a cancer diagnosis they would otherwise have received, because of the impact of the pandemic. The same problems are affecting cancer services globally: a survey conducted by the Union for International Cancer Control (UICC) with over 100 of its member organisations in 55 countries, including civil society, hospitals, research centres and patient support groups, revealed that their income and organisational activities are under significant pressure, with almost three-quarters reporting reductions in income of anywhere from 25% to 100% in 2020 and similar projections for 2021.
Cancer is a global challenge. In 2018, 18 million people world-wide were diagnosed with cancer. Today, thanks to research, one in two people in the UK survive their cancer for 10 years or more. The prospects of major advances in tackling cancer have never been greater, and international collaboration and funding are essential in realising these opportunities. This year’s World Cancer Day, on 4th February, is using the theme ‘I am and I will’ to reinforce the importance and power of cooperation and collective action.
Liver disease is on not just on the rise – it is the now biggest cause of death in those aged between 35 and 49, according to the British Liver Trust. Since 1970, deaths due to liver disease have increased by 400% - and over 40 people die from liver disease in the UK every day.
Two Pronged Prevention Strategy: Vaccination and Testing
The introduction of the Human Papilloma virus (HPV) vaccination in 2008 for adolescent girls in secondary school was a vital step in the prevention of Cervical Cancer. HPV, a common virus that 8 in 10 people will get, is associated with 99% of cervical cancer diagnoses. More than ten million doses of HPV vaccine have been given - over 80% of women aged 15-24 have received the vaccine, protecting this generation from developing cervical cancer in the future.
However, there are millions of women who passed puberty before the vaccine was available, which is why Cervical Screening – previously known as the Smear Test – is so important. During the pandemic, however, the number of smear tests undertaken has dropped – due to a combination of lack of NHS resources and patient fear.
Using the #SmearForSmear campaign tag, Cervical Cancer Prevention Week – 18th to 24th January – is working to make sure as many people as possible know how they can reduce their risk of the disease and to educate others.
Understanding Cervical Cancer
The danger of obesity has come in to sharp relief during the past year, with obesity cited as a key COVID-19 comorbidity. A report from Public Health England concluded that a BMI of 35 to 40 (obese) may increase the risk of death from COVID-19 by 40%, while a BMI of over 40 (morbidly obese) could increase the risk by 90%.
On December 3rd this year, during the annual celebration of people with disabilities, the 2020 theme ‘Not all Disabilities are Visible’ also focuses on spreading awareness and understanding of disabilities that are not immediately apparent, such as mental illness, chronic pain or fatigue, sight or hearing impairments, diabetes, brain injuries, neurological disorders, learning differences and cognitive dysfunctions, among others.
As the world comes together to fight one global pandemic, another still affects millions of people. Globally there are an estimated 38 million people living with HIV – over 100,000 in the UK. More than 35 million people have died of HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immunity Deficiency Syndrome) since it was identified in 1984, making it one of the most destructive pandemics in history.
Life with chronic obstructive pulmonary disease (COPD) can be difficult. It is a progressive condition, there is no cure and everyday tasks can become a challenge. As we head into winter – the deadliest time for people with lung conditions – there is rising concern regarding the dual implications of contracting COVID-19 and the acknowledged backlog in basic care that has occurred over recent months.
One in ten people are living with diabetes, a fact that has been highlighted this year by the COVID-19 pandemic. While age is by far the biggest baseline risk for COVID-19, people with diabetes have been found to be more at risk of dying that others: individuals with Type 1 diabetes have three and a half times the risk, and those with Type 2, twice the risk.
It is time to shave off those lockdown beards and grow the now familiar ‘November Mo’. Since 2003, Movember has funded more than 1,250 men’s health projects around the world, challenging the status quo, shaking up men’s health research and transforming the way health services reach and support men. The charity raises awareness and money for men’s mental health and suicide prevention, prostate cancer and testicular cancer, with the aim of reducing the number of men dying prematurely by 25% before 2030.
Evidence regarding the affect of the Covid-19 pandemic on mental health continues to grow, with more than two-thirds of adults in the UK (69%) feeling somewhat or very worried about the effect Covid-19 is having on their life. With many vulnerable individuals now facing potentially months shielding at home to protect against the second wave, fears regarding a rise in depression, loneliness and anxiety are rising.
Time for Population Health and Individual Screening to Combine to Address Rising Stroke Events
Cardiovascular disease (CVD) is the number one cause of death on the planet. An umbrella term for conditions that affect a person’s heart or circulation, it has many causes: from obesity, diabetes, high blood pressure and cholesterol, to stress, smoking, air pollution, and rare and neglected conditions such as Chagas Disease and cardiac amyloidosis.
On the 26th September, it is World Contraception Day with the mission to spread the word and raise awareness about contraception and safe sex, enabling young people to make informed choices on their sexual and reproductive health.
New treatments for chronic myeloid leukaemia (CML), a form of blood cancer, have transformed patient outcomes over the past 20 years. Tyrosine Kinase Inhibitors (TKI) enable CML to be well controlled for most people, and many individuals will live a normal life span. However, early diagnosis and intervention is key to the effective management of this slowly progressing form of leukaemia.
The prevalence of lymphoma was recently highlighted when former Top Ten tennis player Carla Suarez Navarro withdrew from the US Open following her diagnosis with Hodgkin Lymphoma. Lymphoma is the most common form of blood cancer, with an individual diagnosed every 27 minutes. Over 735,000 people diagnosed with lymphoma, including Chronic Lymphocytic Leukaemia (CLL), every year across the world.
Hepatitis is one of the leading causes of death globally, killing more people each year than AIDS and malaria combined. While these deaths are preventable with the availability of vaccines, effective treatments and a cure for hepatitis C, only 10% of people who live with the disease are aware of their diagnosis. As a result, they may unknowingly transmit the infection to others, before possibly developing fatal liver disease.
Allergy is the most common chronic disease in Europe. Currently affecting more than 150 million people, the EAACI predicts that by 2025 half of the entire EU population will suffer from chronic allergic diseases. Furthermore, up to 20% of patients with allergies struggle daily with the fear of a possible asthma attack, anaphylactic shock or even death from an allergic reaction.
It is just over a decade since the United Nations General Assembly recognised sickle cell disease (SCD) as a public health problem and “one of the world’s foremost genetic diseases.” In 2020, the 15,000 people living with SCD in the UK are in the extremely vulnerable group required to shield during the COVID-19 pandemic.
The implications for mental health of isolation and loneliness have become very apparent over the last few months, but it is a constant issue for those whose lives are continually restricted through illness, such as Multiple Sclerosis (MS). This year’s World MS Day on May 30th is challenging the social barriers that leave people affected by MS feeling lonely and isolated.
The death of TV presenter Caroline Flack just weeks before the COVID-19 induced lockdown inspired an outpouring of national grief. It sparked not only awareness of the need to better understand mental health but also prompted hundreds of thousands of people to share Caroline’s own words on social media: “In a world where you can be anything, be kind."
Leveraging Data to Prioritise Clinical Intervention and Support Self-Care
It takes on average 13 years from first symptoms to achieve a diagnosis of coeliac disease. Often confused with Irritable Bowel Syndrome (IBS), just 30% of people with coeliac disease are currently diagnosed according to Coeliac UK.
There is no cure for Lupus (Systemic Lupus Erythematosus) but symptoms can improve if treatment starts early. The challenge for clinicians is that Lupus presents with so many very different symptoms – including fatigue, rash and kidney problems - which can vary widely from day to day in any one patient.
With the world’s attention now focused on a global pandemic that primarily affects the respiratory system, the 5.4 million people in the UK currently receiving treatment for asthma, including 1.1 million children, already understand the dangers of compromised airways. According to Asthma UK, three people die from an asthma attack every day – and two thirds of these deaths are preventable.
Over two hundred years since Parkinson’s disease was first described by James Parkinson in 1817, there is still no cure for this incredibly disabling illness. The progressive neurological condition affects about 145,000 people in the UK, with estimates of up to 14 million people worldwide. Not only is there no cure, but the primary treatment, the dopamine-replacement therapy Levodopa, was first developed over 50 years ago.
Saving Lives with Better Detection/ Targeted Research
Awareness of mental health has never been higher. But for those with disorders such as bipolar -estimated to be more than one million people in the UK – the escalated stress levels during the current pandemic crisis is likely to have serious implications.
The cost of hidden, undiagnosed disease is widely recognised and is the focus of this year’s World Kidney Day. It is estimated that while three million people in the UK are affected by chronic kidney disease (CKD), up to one million may be undiagnosed.
The end of February marks the 13th International Rare Disease Day. A day aimed at raising awareness about rare diseases and the impact on patient’s lives.
On World Cancer Day, we wanted to show you how THIN® data can be used to generate insights and enable healthcare research to help improve the lives of patients at risk of and living with cancer.
Cegedim has announced an unparalleled European collaboration with Sanofi, delivering Real World Data to improve health.
