Evaluating the NHS Diabetes Prevention Programme (NHS DPP): Assessing whether the NHS DPP is more effective than usual care in reducing conversion of nondiabetic hyperglycaemia to diabetes, eventually reducing diabetes prevalence in England

Date of Approval: 
2018-06-01 00:00:00
Lay Summary: 
Type 2 Diabetes is a common health condition that can cause serious health problems and reduce people’s quality of life, as well as costing a lot of money to treat. Some people are at higher risk of diabetes, and this can be identified with a blood test. If people at risk make changes to their lifestyle they can substantially reduce their chances of getting Type 2 Diabetes. The NHS and Diabetes UK are introducing a new scheme called Healthier You: the NHS Diabetes Prevention Programme (NHS DPP). People in England who are at risk of type 2 diabetes will be offered a practical course which will help them change their lifestyle. The aim is that this course will improve peoples’ health and reduce their diabetes risk. We intend to use the CPRD data to evaluate if the programme works in practice, by comparing the numbers (rates) of people who develop diabetes in two groups: those at risk who have been referred to this programme and those who were not.
Technical Summary: 
Background: The NHS Diabetes Prevention Programme (NHS DPP) is a programme to deliver evidence-based behavioural change intervention to the patients with impaired fasting glucose (IFG) who are at risk of developing type 2 diabetes, this condition is known as non-diabetic hyperglycaemia (NDH), to encourage behaviour change and reduce risk of diabetes. Aim: To evaluate the effectiveness of the NHS DPP by analysis of routine data, to find out whether the NHS DPP leads to the reduction of the prevalence of diabetes and other outcomes, using suitable comparators without access to the NHS DPP. Methods: Data from all CPRD practices participating in the NHS DPP will be used. The conversion rate from nondiabetic hyperglycaemia to Type 2 Diabetes will be compared between the pre-DPP and post-DPP periods within participating practices. A matched cohort study will be used to compare the rates of conversion to diabetes within 3 years between these time periods. Focusing on the post-intervention period, we will also compare within-practices between matched patients referred versus not referred, and also between practices referring to the scheme versus those that are not referring. These analyses assume that reliable information on dates of referral will be available for practices and patients. If that proves to be not the case, a third design will be used that compares practices within areas where the programme is available, to practices in areas where it is not.
Health Outcomes to be Measured: 
 Diabetes - Cardiovascular and diabetes related mortality - At Risk of Diabetes - All-Cause Mortality - Hospitalisation
Application Number: 
18_101
Collaborators: 

Evangelos Kontopantelis - Chief Investigator - University of Manchester
Rathi Ravindrarajah - Corresponding Applicant - University of Manchester
David Reeves - Collaborator - University of Manchester
Simon Heller - Collaborator - University of Sheffield

Linkages: 
HES Accident and Emergency;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation;Non-standard