Uses of Electronic Patient Information Systems and National Registers – Implementation of the Clinical Practice Guideline and Evaluation of Costs and Use of Resources in Patients with Incident Type 2 Diabetes in Finland

Effective management of diabetes is the cornerstone for prevention of diabetic complications. However, how well the Finnish Current Care guideline for diabetes is implemented in practice is unknown. Combining local and nationwide patient registers provide a valuable resource for evaluating risks, benefits and costs. The purpose of this study was to identify how the Finnish electronic patient information systems and national registers can be used to explore the treatment for patients with incident type 2 diabetes. Selected primary and specialty care organizations representing different geographical areas and patient information system providers were invited to participate in the study. Study permits were obtained from several local and nationwide register holders. The study protocol was reviewed by the Ethical Review Board of Hospital District of Helsinki and Uusimaa. Register linkage is accomplished using unique personal identification numbers. We collect nationwide data on prescriptions, hospital and primary care, reimbursed dental care, and the causes of death. Cost data are based on hospital benchmarking database, sickness allowances and rehabilitations. We use local registers as a source of information on diagnoses, medical procedures, prescriptions and contact types. High quality laboratory data are also included from several local providers. Register linkages enable longitudinal follow-up of patients for research purposes in Finland. In our study a unique combined register database of diabetic patient cohort is created that improves the evaluation of prognosis and care of diabetic patients. This is a promising and versatile source for research in pharmacoepidemiology.