In 2017, the Groningen Research Institute of Pharmacy, the departments of Epidemiology and Clinical Pharmacy&Pharmacology of the University Medical Center Groningen, and the Lifelines Cohort Study
(see started the PharmLines Initiative to link data of the Lifelines Cohort Study to the University Groningen prescription database,
In the PharmLines Initiative, both databases from the Lifelines Cohort Study and are linked by Statistics Netherlands (CBS) which act as Third Trusted Party at the patient level using deterministic
linkage on the basis of unique identifiable information.

The Lifelines Cohort Study was established in the North of the Netherlands between 2006 and 2013 as an academic resource for researchers worldwide. The study design concerns an observational follow-up study with long-term
prospective measurements in a large population aiming to explore the interaction between genetic and environmental factors in the development of multifactorial diseases. In short, since all inhabitants in The Netherlands are
registered with a general practitioner (GP), eligible participants were invited to participate in the Lifelines Cohort Study through their GP. A large number of GPs within the northern three provinces of The Netherlands
(Friesland, Groningen and Drenthe) were involved and invited all their patients between the ages of 25 and 50 years, unless the participating GP considered the patient not eligible based on the following criteria: severe psychiatric
or physical illness; limited life expectancy (<5 years); or insufficient knowledge of the Dutch language to complete a Dutch questionnaire. Subsequently, individuals who were interested to participate received detailed information
by mail about the Lifelines Cohort Study and an informed consent form. After the signed informed consent was received by the Lifelines organization, the participants received a baseline questionnaire and an invitation to a
comprehensive health assessment at the Lifelines research site. More than 167,000 persons from the three Northern provinces of the Netherlands participated in this three-generation study. During the entry period, participants
completed a number of questionnaires, underwent a medical examination, and biological samples including DNA were collected and stored. Methods that were employed to obtain information on the medication use were

(1) by asking the participants about their medication use through a questionnaire and
(2) by bringing their used medications at the time of the interview.

All medications were then recorded by a doctor’s assistant. All prescribed medications were classified according to the ATC (Anatomical Therapeutic Chemical) coding scheme.

Reference: Scholtens S, Smidt N, Swertz MA, et al. Cohort profile: LifeLines, a three-generation cohort study and biobank. Int J Epidemiol. 2015;44(4):1172-80.