Case study · Real world evidence and research · Published 26 October 2026
Promatica is working with a global biopharmaceutical company on palmoplantar pustulosis (PPP), a chronic inflammatory condition of the hands and feet that is hard to see in primary care data. Using PRISM, we built a clinically validated way to find people with PPP in GP records. That work now supports a UK real world evidence study and recruitment into a clinical trial, and has led to a second programme with the same partner.
At a glance
Partner
Global biopharmaceutical company
Condition
Palmoplantar pustulosis
Data
Coded GP records from EMIS Web and SystmOne, via PRISM
Phenotype
Three tier hierarchy across 25 clinical code sets, with pharmacist review
Uses
Real world evidence (prevalence, patient pathway, burden of disease) and clinical trial recruitment
Status
Pharmacist case review and trial site recruitment under way, October 2026
The challenge
PPP is uncommon, and in GP records it rarely appears cleanly. It can be coded under several different clinical terms, the familiar abbreviation “PPP” is not a code at all, and it is often recorded as something else: hand eczema, pompholyx or plaque psoriasis. Treatment spans the full range of dermatology medicines, most of them used off label, so prescribing alone does not identify it either.
Our partner needed UK evidence on how many people live with PPP, how they are treated and what the condition costs them and the NHS. It also needed to find eligible people for a clinical trial. Both depended on identifying PPP accurately in primary care data.
What we did
We worked through the programme in stages, with our partner’s clinical, evidence and governance teams reviewing each step.
Shaping the study. Promatica provided primary care and data expertise to the real world evidence protocol as it went through our partner’s internal scientific review.
Defining the phenotype. We built a three tier hierarchy, from confirmed diagnosis through to probable cases, across 25 code sets covering diagnoses, treatments and likely miscoding. Terms that are easily confused with PPP are flagged for review rather than counted automatically.
Making it visible. We built tooling to visualise the code sets so our partner’s clinicians could review and approve them concept by concept.
Proving the cohort. Early analysis across PRISM practices verified that the cohort exists in sufficient numbers before full analysis began.
Pharmacist review. Promatica pharmacists engage practices and review patient records to confirm cases, giving a measured accuracy for each tier of the phenotype.
Trial recruitment. The same foundations now support recruitment into a PPP clinical trial, using a separate search built around the trial’s own criteria and lawful basis.
All of this runs on routine GP data, within PRISM’s NHS information governance framework, with Promatica pharmacists carrying out the record review.
Where it has led
As of October 2026, pharmacist case review is under way and practices are being engaged for trial recruitment. The early success of the PPP work has led the same partner to commission a second PRISM programme with Promatica, in paediatric hidradenitis suppurativa.
The programme shows what PRISM is built to do: take a condition that is hard to see in routine data, define it with clinical rigour, check it against the patient record, and then put it to work for evidence generation and research recruitment in the same network of practices.
Work with us
For life sciences
If your evidence or recruitment plans depend on finding a hard to identify population in UK primary care, we can help you define it, validate it and reach it.
For the NHS
PRISM practices take part in research and evidence programmes like this one, helping patients with less common conditions get recognised and offered new options.