Big data from EHRs bolsters drug research

With the help of big data, researchers have discovered that the combination of two drugs can significantly lower patients' blood pressure, according to a study published in the Journal of General Internal Medicine.

The drugs included one often prescribed to conserve potassium in the blood and a diuretic frequently prescribed to patients with hypertension, according to the researchers, who hail from the Regenstrief Institute and Indiana University.

The researchers studied de-identified information from the electronic medical records of 17,291 hypertensive patients treated between 2004 and 2012. The patients were prescribed the diuretic hydrochlorothiazide with or without triamterene, a drug commonly prescribed to conserve potassium in the blood, according to an announcement.

"It is unlikely that a large clinical trial would be conducted to reexamine the blood pressure effect of triamterene, a drug that has been on the market since 1965," lead researcher Wanzhu Tu, a Regenstrief Institute investigator and a professor of biostatistics at IU School of Medicine, says in the announcement. "Yet smaller clinical trials simply do not provide sufficient power to determine the drug's effect. Observational studies based on big data, like ours, provide a viable alternative."

The researchers also looked at the effects of triamterene when patients were taking antihypertensive agents, such as ACE inhibitors and calcium channel blockers. They found that the mean systolic BP in the group taking triamterene and hydrochlorothiazide together was 3.8 mmHG lower than those taking only hydrochlorothiazide. Lower BP of 1 to 4 mmHG was found in subgroups taking triamterene in combination with other drugs.

Innovation in drug development, however, is often hindered by regulation. A new report by the Bipartisan Policy Center provides policy actions that Congress can undertake when it comes to reducing the time and cost of developing drugs and devices and delivering them into the healthcare marketplace. Specifically, the report examines how to "modernize the development of drugs and devices," especially when it comes to the work of the U.S. Food and Drug Administration.

Big data is also being used at other hospitals to advance care. Advocate Health Care is using data to predict readmission risks, and Penn Medicine has a number of data projects under way using its clinical data warehouse that holds records on 3 million patients going back 10 years. 

To learn more:
- here's the study
- read the announcement