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Article History

Received: 22 October 2025

Accepted: 5 January 2026

First Online: 9 January 2026

Declarations

:

: Author DP has advisory board membership with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; consultancy agreements with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; grants and unrestricted funding for investigator-initiated studies (conducted through Observational and Pragmatic Research Institute Pte Ltd) from AstraZeneca, Chiesi, Viatris, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, and UK National Health Service; payment for lectures/speaking engagements from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Inside Practice, GlaxoSmithKline, Medscape, Viatris, Novartis, Regeneron Pharmaceuticals and Sanofi Genzyme, Teva Pharmaceuticals; payment for travel/accommodation/meeting expenses from AstraZeneca, Boehringer Ingelheim, Novartis, Medscape, Teva Pharmaceuticals; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 92.61% of Observational and Pragmatic Research Institute Pte Ltd (Singapore); 5% shareholding in Timestamp which develops adherence monitoring technology; is peer reviewer for grant committees of the UK Efficacy and Mechanism Evaluation programme, and Health Technology Assessment; and was an expert witness for GlaxoSmithKline. Author NE is an employee of Optimum Patient Care Global (OPCG) and Observational and Pragmatic Research Institute (OPRI). All other authors declare no financial or non-financial competing interests.

: The study protocol was approved by the Human Research Ethics Committee (HREC) of the University of New South Wales (iRECS6645) and Anonymized Data Ethics and Protocol Transparency (ADEPT) Committee (ADEPT0224), performed in compliance with Good Clinical Practice and Good Pharmacoepidemiology Practice and registered with the European Union Electronic Register of Post-Authorization studies (EUPAS1000000018). The Optimum Patient Care Research Database (OPCRD) is established and maintained by Optimum Patient Care (OPC) Ltd. The OPCRD is approved by the UK National Health Service for clinical research use (Research Ethics Committee reference 15/EM/0150).