Does RWE Influence Clinical Practice?

Data about Real-World patient experiences have the potential to improve the medical care. It’s plausible that RWE can reduce costs and improve outcomes, and boost how we implement new therapies and technologies. These data help to fill the gap between clinical trials and actual clinical practice.

We know the pharma industry has embraced the use of Real-World Evidence (RWE). What is less clear though, is how RWE has influenced clinical practice in the UK.

Better trials means better quality evidence to work from

We have discussed various problems that clinical trials face (recruitment, retention, feasibility studies). Improving quality of trials through use of RWE ensures that the evidence generated is of a high quality. High quality evidence provides policymakers with good quality information with which to make decisions. Pragmatic trials are central to this idea, and Real-World approaches have been proven as an effective way to test new medicines.

We know generating RWE is worthwhile, but how long does it take for these results to change clinical practice?

A systematic review published in 2016 by researchers based at the governmental primary care data provider the Clinical Practice Research Datalink (CPRD). This study looked at national guidelines or guidance published in England from 2000 onwards that explicitly referenced studies that used data generated by the CPRD service.

The Good News

• 25 guidance documents that reference 43 of these Real-World studies were included in the review
• All were recently published (since 2007)
• Documents covered 12 disease areas and included information on: disease epidemiology, incidence/prevalence, pharmacoepidemiology, pharmacovigilance and health utilisation
• There seems to be an increasing trend in the use of healthcare system data to inform clinical practice

The Bad News

Though RWE is being used to design guidelines, the uptake of these data are slow. We know there is an increasing trend in the use of data from our healthcare systems to inform clinical practice, but this demand is running ahead of the infrastructure available. We need organisations to work together to enable or improve data access, undertake translational and relevant research and establish sources of reliable evidence. At the centre of this is the digitisation of the NHS (our own Richard Yeatman named this as his main hope for future tech advancement here).