The introduction of a prescribing database as a new tool for disease surveillance (March 2009–March 2010), and its future potential for record linkage. The assessment of population health has traditionally focused on mortality data because it is readily available and there are systematic methods of data collection which are recognised internationally. However, morbidity data are now considered more relevant to current public health concerns, though inherently less accessible. We show how linkage of routine health data can supplement and complement mortality data to produce information that is pertinent to both research and policy making. We use diabetes, a worldwide chronic disease, driven by trends in obesity and ageing populations, as an exemplar. There are an estimated 285 million adults aged 20–79 living with diabetes worldwide yet there is a paucity of successful surveillance tools to measure the burden of this disease. Between March 2009 and March 2010 3.4% of the population cashed prescriptions for anti-diabetic medication (n=63 853) with multilevel analysis showing an increased association with older age, males and increased deprivation. This study shows how the prevalence of diabetes in one country (Northern Ireland–c1.8 million) has been estimated from prescription data relating to treated diabetes. These estimates will be strengthened with linkages to data from laboratories measuring diabetic control and data from primary care used to inform the diabetic retinopathy screening services.
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