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Ala Keyany, Johannes T H Nielen, Patrick C Souverein, Frank de Vries, Bart van den Bemt
BACKGROUND: Use of oral glucocorticoids (GCs) has been associated with hyperglycaemia and type 2 diabetes mellitus (T2DM). However, unlike oral GCs, there is minimal or no data on the effect of parenteral GC use on T2DM. OBJECTIVE: To assess the association between use of parenteral GCs and the risk of receiving a first prescription of a non-insulin antidiabetic drug (NIAD) as a proxy for new onset of T2DM. METHODS: A population based case-control study was performed using the Clinical Practice Research Datalink (CPRD)...
February 22, 2018: Diabetes Research and Clinical Practice
L R Vaz, M J Jones, L Szatkowski, L J Tata, S Petrou, T Coleman
BACKGROUND AND AIMS: Little is known about the long term economic consequences of smoking during pregnancy. We estimated the association between smoking in pregnancy and the costs of delivering healthcare to infants and children in England, and investigated which aspects of care are the key drivers of these costs. METHODS: We used Hospital Episode Statistics (HES) linked with Clinical Practice Research Datalink (CPRD) data in England from January 2003 until January 2015 in children with longitudinal data for at least one, five and ten years after birth...
February 3, 2018: Addiction
Samuel W D Merriel, Margaret T May, Richard M Martin
INTRODUCTION: Prostate cancer is the most common cancer in men in the UK, with nearly 40 000 diagnosed in 2014; and it is the second most common cause of male cancer-related mortality. The clinical conundrum is that most men live with prostate cancer rather than die from it, while existing treatments have significant associated morbidity. Recent studies have shown very low mortality rates (1% after a median of 10-year follow-up) and no treatment-related reductions in mortality, in men with localised prostate cancer...
January 31, 2018: BMJ Open
Amy Matcho, Patrick Ryan, Daniel Fife, Dina Gifkins, Chris Knoll, Andrew Friedman
Administrative claims and electronic health records are valuable resources for evaluating pharmaceutical effects during pregnancy. However, direct measures of gestational age are generally not available. Establishing a reliable approach to infer the duration and outcome of a pregnancy could improve pharmacovigilance activities. We developed and applied an algorithm to define pregnancy episodes in four observational databases: three US-based claims databases: Truven MarketScan® Commercial Claims and Encounters (CCAE), Truven MarketScan® Multi-state Medicaid (MDCD), and the Optum ClinFormatics® (Optum) database and one non-US database, the United Kingdom (UK) based Clinical Practice Research Datalink (CPRD)...
2018: PloS One
Claudia Becker, Cornelia Schneider, Samuel Aballéa, Clare Bailey, Rupert Bourne, Susan Jick, Christoph Meier
AIMS: To analyze the risk of incident cataract (diagnosis or extraction) in patients with or without diabetes focusing on other comorbid conditions, antidiabetic drug use, and diabetes duration. METHODS: The study population comprised newly diagnosed diabetes patients (≥40 years) from the UK-based Clinical Practice Research Datalink (CPRD) between 2000 and 2015, and a random sample of the general population matched for age, sex, general practice, and year of diabetes diagnosis...
February 1, 2018: Eye
John M Dennis, Beverley M Shields, Anita V Hill, Bridget A Knight, Timothy J McDonald, Lauren R Rodgers, Michael N Weedon, William E Henley, Naveed Sattar, Rury R Holman, Ewan R Pearson, Andrew T Hattersley, Angus G Jones
OBJECTIVE: A precision approach to type 2 diabetes therapy would aim to target treatment according to patient characteristics. We examined if measures of insulin resistance and secretion were associated with glycemic response to dipeptidyl peptidase 4 (DPP-4) inhibitor therapy. RESEARCH DESIGN AND METHODS: We evaluated whether markers of insulin resistance and insulin secretion were associated with 6-month glycemic response in a prospective study of noninsulin-treated participants starting DPP-4 inhibitor therapy (Predicting Response to Incretin Based Agents [PRIBA] study; n = 254), with replication for routinely available markers in U...
January 31, 2018: Diabetes Care
Karin W Littink, Patricia T Y Stappers, Frans C C Riemslag, Herman E Talsma, Maria M van Genderen, Frans P M Cremers, Rob W J Collin, L Ingeborgh van den Born
Enhanced S-cone syndrome (ESCS) is mainly associated with mutations in the NR2E3 gene. However, rare mutations in the NRL gene have been reported in patients with ESCS. We report on an ESCS phenotype in additional patients with autosomal recessive NRL (arNRL) mutations. Three Moroccan patients of two different families with arNRL mutations were enrolled in this study. The mutation in the DNA of one patient, from a consanguineous marriage, was detected by homozygosity mapping. The mutation in the DNA of two siblings from a second family was detected in a targeted next-generation sequencing project...
January 30, 2018: Genes
Meritxell Sabidó, Thilo Hohenberger, Guido Grassi
The study objective was to compare the long-term incidence and risk of mortality and cardiovascular outcomes in patients with hypertension initiating bisoprolol, other β-blockers or other antihypertensive therapies. Cohort analysis using UK Clinical Practice Research Datalink (CPRD). Adult patients with first diagnosis of hypertension recorded between 2000 and 2014, with ≥365 days of registration to first event and initiating monotherapies of bisoprolol, other β-blockers or drugs other than β-blockers within 6 months of diagnosis were included...
January 31, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Tanvir Khan, Abtin Alvand, Daniel Prieto-Alhambra, David J Culliford, Andrew Judge, William F Jackson, Brigitte E Scammell, Nigel K Arden, Andrew James Price
OBJECTIVES: The aim of this study was to investigate whether ACL injury (ACLi) or meniscal injury increases the risk of end-stage osteoarthritis (OA) resulting in total knee replacement (TKR). METHODS: A matched case-control study of all TKRs performed in the UK between January 1990 and July 2011 and recorded in the Clinical Practice Research Datalink (CPRD) was undertaken. The CPRD contains longitudinal data on approximately 3.6 million patients. Two controls were selected for each case of TKR, matched on age, sex and general practitioner location as a proxy for socioeconomic status...
January 13, 2018: British Journal of Sports Medicine
M Elle Saine, Mona Gizaw, Dena M Carbonari, Craig W Newcomb, Jason A Roy, Serena Cardillo, Daina B Esposito, Harshvinder Bhullar, Arlene M Gallagher, Brian L Strom, Vincent Lo Re
PURPOSE: Identification of hospitalizations for infection is important for post-marketing surveillance of drugs, but the validity of using diagnosis codes to identify these events is unknown. Differentiating between hospitalization for and with infection is important, as the latter is common and less likely to arise from pre-admission exposure to drugs. We determined positive predictive values (PPVs) of diagnostic coding-based algorithms to identify hospitalization for infection among patients prescribed oral anti-diabetic drugs (OADs)...
December 18, 2017: Pharmacoepidemiology and Drug Safety
Fariba Ahmadizar, Patrick Souverein, Anthonius de Boer, Anke H Maitland-van der Zee
AIMS: The aims of the present study were, firstly, to evaluate long-term trends in the occurrence and treatment of cardiovascular disease (CVD) risk factors and the occurrence of CVD events in children with type 1 diabetes mellitus (T1DM) and, secondly, to assess the determinants of undertreatment of CVD risk factors. METHODS: A retrospective cohort study was conducted in 3728 children (<19 years of age) with T1DM and up to 5 age- and gender-matched diabetes-free children (reference cohort) (n = 18 513) using data from the Clinical Practice Research Datalink (CPRD)...
December 7, 2017: British Journal of Clinical Pharmacology
Brett Doble, Rupert Payne, Amelia Harshfield, Edward C F Wilson
OBJECTIVES: To investigate patterns of early repeat prescriptions and treatment switching over an 11-year period to estimate differences in the cost of medication wastage, dispensing fees and prescriber time for short (<60 days) and long (≥60 days) prescription lengths from the perspective of the National Health Service in the UK. SETTING: Retrospective, multiple cohort study of primary care prescriptions from the Clinical Practice Research Datalink. PARTICIPANTS: Five random samples of 50 000 patients each prescribed oral drugs for (1) glucose control in type 2 diabetes mellitus (T2DM); (2) hypertension in T2DM; (3) statins (lipid management) in T2DM; (4) secondary prevention of myocardial infarction; and (5) depression...
December 4, 2017: BMJ Open
E Martín-Merino, I Petersen, S Hawley, A Álvarez-Gutierrez, S Khalid, A Llorente-Garcia, A Delmestri, M K Javaid, T P Van Staa, A Judge, C Cooper, D Prieto-Alhambra
The venous thromboembolism risk among anti-osteoporotics is unknown. In this primary care study, the risk with other bisphosphonates [1.05 (0.94-1.18) and 0.96 (0.78-1.18)], strontium [0.90 (0.61-1.34) and 1.19 (0.82-1.74)], in the UK and Spain respectively, and denosumab [1.77 (0.25-12.66)] and teriparatide [1.27 (0.59-2.71)] in Spain, did not differ versus alendronate. INTRODUCTION: Most of the known adverse drug reactions described for anti-osteoporosis medication (AOM) have been described in studies comparing AOM users to non-users...
February 2018: Osteoporosis International
Andreia Leite, Sara L Thomas, Nick J Andrews
PURPOSE: Near real-time vaccine safety surveillance (NRTVSS) using electronic health records has been used to detect timely vaccine safety signals. Trial implementation of NRTVSS using the Clinical Practice Research Datalink (CPRD) has shown that there is limited power to detect safety signals for rare events. Delays in recording outcomes and receiving data influence the power and timeliness to identify a signal. Our work aimed to compare how different sources of delays influence power and expected time to signal to implement NRTVSS using CPRD...
January 2018: Pharmacoepidemiology and Drug Safety
Anu Jain, Albert J van Hoek, Jemma L Walker, Rohini Mathur, Liam Smeeth, Sara L Thomas
Identification and quantification of health inequities amongst specific social groups is a pre-requisite for designing targeted healthcare interventions. This study investigated the recording of social factors in linked electronic health records (EHR) of individuals aged ≥65 years, to assess the potential of these data to identify the social determinants of disease burden and uptake of healthcare interventions. Methodology was developed for ascertaining social factors recorded on or before a pre-specified index date (01/01/2013) using primary care data from Clinical Practice Research Datalink (CPRD) linked to hospitalisation and deprivation data in a cross-sectional study...
2017: PloS One
Nathalie Conrad, Andrew Judge, Jenny Tran, Hamid Mohseni, Deborah Hedgecott, Abel Perez Crespillo, Moira Allison, Harry Hemingway, John G Cleland, John J V McMurray, Kazem Rahimi
BACKGROUND: Large-scale and contemporary population-based studies of heart failure incidence are needed to inform resource planning and research prioritisation but current evidence is scarce. We aimed to assess temporal trends in incidence and prevalence of heart failure in a large general population cohort from the UK, between 2002 and 2014. METHODS: For this population-based study, we used linked primary and secondary electronic health records of 4 million individuals from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex...
November 21, 2017: Lancet
Judith van Dalem, Martijn C G J Brouwers, Coen D A Stehouwer, André Krings, Olaf H Klungel, Johanna H M Driessen, Frank de Vries, Andrea M Burden
We investigated the association between the current use of individual sulphonylureas and the risk of a first-ever acute myocardial infarction (AMI) and all-cause mortality, in a population-based cohort study, using primary care data from the Clinical Practice Research Datalink database (2004-2012). New users (N = 121 869), aged ≥18 years, with at least one prescription for a non-insulin antidiabetic agent were included. The first prescription defined start of follow-up. Time-dependent Cox proportional hazard models were used to estimate the risk of a first-ever AMI and all-cause mortality associated with the use of individual sulphonylureas, and other non-insulin glucose-lowering drugs...
November 24, 2017: Diabetes, Obesity & Metabolism
Jessica Watson, Brian D Nicholson, Willie Hamilton, Sarah Price
OBJECTIVE: Analysis of routinely collected electronic health record (EHR) data from primary care is reliant on the creation of codelists to define clinical features of interest. To improve scientific rigour, transparency and replicability, we describe and demonstrate a standardised reproducible methodology for clinical codelist development. DESIGN: We describe a three-stage process for developing clinical codelists. First, the clear definition a priori of the clinical feature of interest using reliable clinical resources...
November 22, 2017: BMJ Open
Sarah Stevens, Clare Bankhead, Toqir Mukhtar, Rafael Perera-Salazar, Tim A Holt, Chris Salisbury, F D Richard Hobbs
OBJECTIVES: Consultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care. DESIGN AND SETTING: Cross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement...
November 16, 2017: BMJ Open
Anjali Shah, Andrew Judge, Antonella Delmestri, Katherine Edwards, Nigel K Arden, Daniel Prieto-Alhambra, Tim A Holt, Rafael A Pinedo-Villanueva, Sally Hopewell, Sarah E Lamb, Amar Rangan, Andrew J Carr, Gary S Collins, Jonathan L Rees
OBJECTIVE: This cohort study evaluates the unknown age-specific and gender-specific incidence of primary shoulder dislocations in the UK. SETTING: UK primary care data from the Clinical Practice Research Datalink (CPRD) were used to identify patients aged 16-70 years with a shoulder dislocation during 1995-2015. Coding of primary shoulder dislocations was validated using the CPRD general practitioner questionnaire service. PARTICIPANTS: A cohort of 16 763 patients with shoulder dislocation aged 16-70 years during 1995-2015 were identified...
November 14, 2017: BMJ Open
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