Article type
Abstract
"Background
The National Institute of Health and Care Excellence (NICE) strives to address and mitigate health inequalities in its recommendations and prevent them from worsening. Historically, NICE has primarily relied on published evidence or committee expertise to identify health inequality issues that might be impacted by its recommendations. However, with the increased availability and quality of real-world data, there is growing opportunity for NICE to improve its current approach. Here we present two case studies: 1) a completed analysis that shows the feasibility and potential value of such work; 2) a project currently underway to explore the health and economic impact of unwarranted variations in uptake of NICE recommended medicines for Type 2 Diabetes (T2D). These demonstrate how NICE can use real-world data to identify health inequalities at two stages of the guideline development process.
Objectives
To explore inequalities in uptake of treatments recommended in NICE guidelines using real world data.
Methods
The first project used the HQIP National Clinical Audit of Psychosis to explore inequalities in the receipt of NICE recommended psychotherapies across Early Intervention in Psychosis (EIP) services in England. The T2D project is using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics datasets to obtain demographic and clinical data on the affected population and evaluate current inequalities in NICE recommended treatment. The T2D project will use a distributional analysis using real world data to explore health inequalities in the uptake of its recommended treatments.
Results
In the EIP analysis, pervasive inequalities were identified. Compared with White British people, almost every minoritized ethnic group were less likely to receive NICE recommended psychotherapies. The results of the T2D project are pending and are expected to be available by the time of the conference.
Discussion
These results highlight a crucial issue for guideline developers: the presence of unequal and possibly discriminatory implementation of their recommended treatments. Our ongoing work will demonstrate the impact of differential uptake of existing and new recommended treatments on inequalities in health outcomes. Through these case studies NICE aims to enhance its understanding and reduction of health inequalities in health and care practices. "
The National Institute of Health and Care Excellence (NICE) strives to address and mitigate health inequalities in its recommendations and prevent them from worsening. Historically, NICE has primarily relied on published evidence or committee expertise to identify health inequality issues that might be impacted by its recommendations. However, with the increased availability and quality of real-world data, there is growing opportunity for NICE to improve its current approach. Here we present two case studies: 1) a completed analysis that shows the feasibility and potential value of such work; 2) a project currently underway to explore the health and economic impact of unwarranted variations in uptake of NICE recommended medicines for Type 2 Diabetes (T2D). These demonstrate how NICE can use real-world data to identify health inequalities at two stages of the guideline development process.
Objectives
To explore inequalities in uptake of treatments recommended in NICE guidelines using real world data.
Methods
The first project used the HQIP National Clinical Audit of Psychosis to explore inequalities in the receipt of NICE recommended psychotherapies across Early Intervention in Psychosis (EIP) services in England. The T2D project is using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics datasets to obtain demographic and clinical data on the affected population and evaluate current inequalities in NICE recommended treatment. The T2D project will use a distributional analysis using real world data to explore health inequalities in the uptake of its recommended treatments.
Results
In the EIP analysis, pervasive inequalities were identified. Compared with White British people, almost every minoritized ethnic group were less likely to receive NICE recommended psychotherapies. The results of the T2D project are pending and are expected to be available by the time of the conference.
Discussion
These results highlight a crucial issue for guideline developers: the presence of unequal and possibly discriminatory implementation of their recommended treatments. Our ongoing work will demonstrate the impact of differential uptake of existing and new recommended treatments on inequalities in health outcomes. Through these case studies NICE aims to enhance its understanding and reduction of health inequalities in health and care practices. "