1. Study identification
EU PAS Register NumberEUPAS8202
Official titleA retrospective nationwide cohort study to investigate the treatment of type 2 diabetic patients in Finland - DAHLIA
Study title acronymDAHLIA
Study typeObservational study
Brief description of the studyThere are about 280,000 people diagnosed with diabetes receiving medical treatment in Finland, most of them (85%) with type 2 diabetes mellitus (T2DM). T2DM is initially managed by life style changes only, but patients failing to control their blood glucose levels start eventually also using oral antidiabetic drugs (OADs). When the disease proceeds, many patients will need treatment with an injectable glucose-lowering drug (glucagon-like peptide-1 receptor agonist or insulin) in addition to OADs. Many new medicines have conquered the market in the recent years, but it is not completely known in detail how the glucose-lowering agents are used in a real-life setting. It would be important to understand the treatment journey in relation to disease progression and switches between different treatment levels in practice.
The purpose of the study is to describe type 2 diabetes mellitus patients in Finland, especially their antidiabetic medication use (e.g. persistence, concomitance and switching), and to discuss the progression of the disease in terms of comorbidities and drug treatment. As a secondary objective the study includes health economic characteristics.
As the study period lasts until 2013 (the latest year currently available from nationwide registers), the study setting includes also the newest drug groups on the market. A parallel study is conducted in Sweden, which makes between-country comparison possible. The enrolment of similar studies also in Norway and Denmark is under planning and therefore it would be feasible to compare the results from four Nordic countries in near future.
Approximately 240 000 Finnish T2DM patients will be studied in 1998-2013 by using data from nationwide patient registers.
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
Not applicable
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Department/Research group
Organisation/affiliationEPID Research Oy
Details of (Primary) lead investigator
Title Dr
Last name Hoti
First name Fabian
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
National study
Finland
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed02/09/201402/09/2014
Start date of data collection31/01/201611/12/2015
Start date of data analysis30/11/201603/03/2017
Date of interim report, if expected
Date of final study report30/09/201714/11/2017
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAstraZeneca Nordic Baltic100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Hoti
First name Fabian
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-40-5391919
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Hoti
First name Fabian
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-40-5391919
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)A10 (DRUGS USED IN DIABETES)
7. Medical conditions to be studied
Medical condition(s)Yes
Type 2 diabetes mellitus
8. Population under study
Age
Children (2 - 11 years)
Adolescents (12 - 17 years)
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects350000
10. Source of data
Is this study being carried out with an established data source?No
Sources of data
Administrative database, e.g. claims database
Pharmacy dispensing records
Causes of Death Registry, National Prescription Register including drug purchases and reimbursement decisions, National Hospital Care Register, National Primary Care Register, National register for institutionalizations (other than hospitalizations), Sickness allowance register, Statistical pension register
11. Scope of the study
What is the scope of the study?
Drug utilisation study
Primary scope : Drug utilisation study
12. Main objective(s)
What is the main objective of the study?
The purpose of the study is to describe type 2 diabetes mellitus patients in Finland, especially their antidiabetic medication use (e.g. persistence, concomitance and switching), and to discuss the progression of the disease in terms of comorbidities and drug treatment. As a secondary objective the study includes health economic characteristics.
Are there primary outcomes?No
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
Drug utilisation study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
After the index date (cohort entry date) the patients will be followed-up until moving abroad, death or the end of year 2014, whichever occurs first.
15. Data analysis plan
Please provide a brief summary of the analysis method
R language will be used for in data management for creating the analysis database and in statistical analysis for creating tabulations and graphics as well as in all statistical modelling.
The annual prevalent and incident population will be described on yearly basis from 1998 to end of follow-up (year 2014). The summaries will include patient demographics, comorbidities, use of blood glucose-lowering drugs and use of other drugs. Incident population will be described on index date and prevalent population on the 1st of July. Both counts and percentages will be given.If a variable is totally missing it is excluded from the analysis.
If a variable is missing for only some of the patients a missing data category is added and used in the analysis.
The principles of the statistical analysis by objectives are outlined in protocol. More detailed statistical analysis plans will be written separately.