Understanding cardiometabolic co-morbidity across primary and secondary care

By 2035, it is estimated that 1 in 5 people in the UK will have 4 or more diseases, with the most common affecting the blood vessels and heart. The direct expected healthcare cost of, for example, heart failure alone in only the US is predicted to rise to $53 billion by the next decade. This is the biggest current problem facing healthcare systems and patients worldwide. There is a lack of science solutions to making sure that preventative and treatment strategies address the widest population that can be accessed. This has been partly hampered by a lack of studies involving patients who have agreed to be contacted again for research that are truly representative of the population needed to address these questions effectively

We have established a national consented study population of patients (AccessCMD) and anticipate recruiting a total of 50,000 patients within the first 12 months.

To properly understand how comparable this prospective registry is of the general population, we need to build parallel “real world” datasets that can validate our data and observations. An example of how this works in practice is in treating obesity with newly licensed weight loss drugs (called GLP-1 agonists).-We are able to show how many patients would potentially benefit from these new types of drugs. We need, however, to be able to be clear that these estimates are applicable to the wider population (including patients who choose not to sign up to research studies).

Using this data we can also look at what the healthcare costs and benefits are likely to be. The recent changes in NICE guidance/commissioning on GLP-1 have not yet been explored in primary and secondary care populations. Data from AccessCMD demonstrates that less than 5 % of obese patients are eligible for primary care prescribed therapy and 42% of these patients are already on a GLP-1 agonist. If the consented dataset is representative of the population data, then the governments current plans for the rollout of weight loss programmes will need to be reconsidered. There is the possibility this project could be the first to explore the recent changes in these populations for commission labelling.