====== Early Treatment Pathways in Chronic Disease ======


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**Objective:** The objective of this study is to characterize the prevalence of different initial treatment pathways for three chronic diseases: Hypertension, Type II Diabetes, and Depression.  We will systematically summarize the treatment pathways observed among patients who have at least **12 months** of continuous observation and persistent treatment following drug initiation.  We will stratify the results by year to evaluate temporal trends, and will further stratify by data source to determine if treatment pathways vary by population, geography, and data capture process.

**Rationale:** While numerous treatment guidelines exist for chronic conditions, there is a paucity of data on the real-world treatment pathways that patients experience in practice. Understanding these pathways is essential for establishing context around questions of drug utilization, effectiveness, and adherence. 

**Project Leads:** Patrick Ryan, Jon Duke, Rich Boyce, George Hripcsak, Martijn Schuemie, Nigam Shah

**Coordinating Institution(s):** Janssen R&D, Regenstrief Institute, University of Pittsburgh, Columbia University, Stanford University

** Additional Participants:**

**Full Protocol:** [[https://github.com/OHDSI/StudyProtocols/blob/master/Study%202%20-%20Treatment%20Pathways%2012mo/OHDSITreatmentPathwaysinChronicDisease12monthprotocol.docx?raw=true|Chronic Disease Treatment Pathways 12-month Protocol]]

**Initial Proposal Date:**  2/2/2015

**Launch Date:**  Target 2/16/2015

**Study Closure Date:**  Pending

**Results Submission:** [[mailto:jonduke@regenstrief.org|Email]] or SFTP

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===== Requirements =====
**CDM:** V4 or V5

**Database Dialect:** SQL Server, Postgres, Oracle

**Software:**  SQL as above, R >=3.1
 
===== Code ===== 
[[https://github.com/OHDSI/StudyProtocols/tree/master/Study%202%20-%20Treatment%20Pathways%2012mo|Github Repo]]

===== Discussion ===== 
[[http://forums.ohdsi.org/t/ohdsi-study-2-study-on-early-treatment-pathways-in-chronic-disease/273/2|Treatment Pathways Discussion Thread]] 

===== Datasets Run ===== 
  * Optum
  * GE
  * CCAE
  * Stanford STRIDE
  * Indiana Network for Patient Care


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