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Cristina Varas-Lorenzo, Alejandro Arana, Catherine B Johannes, Lisa J McQuay, Kenneth J Rothman, Daniel Fife
BACKGROUND: The ascertainment of sudden cardiac death (SCD) in electronic health databases is challenging. OBJECTIVES: Our objective was to evaluate the applicability of the validated computer definition of SCD developed by Chung et al. in a retrospective study of SCD and domperidone exposure in the Clinical Practice Research Datalink (CPRD). METHODS: We assessed out-of-hospital SCD by applying the validated computer definition and linking data with Hospital Episode Statistics and death certificates...
September 2016: Drugs—Real World Outcomes
R Y van der Velde, C E Wyers, E Teesselink, P P M M Geusens, J P W van den Bergh, F de Vries, C Cooper, N C Harvey, T P van Staa
INTRODUCTION: Given the expected increase in the number of patients with osteoporosis and fragility fractures it is important to have concise information on trends in prescription rates of anti-osteoporosis drugs (AOD). METHODS: We undertook a retrospective observational study using the UK Clinical Practice Research Datalink (CPRD) in the UK between 1990 and 2012 in subjects 50years or older, stratified by age, sex, geographic region and ethnicity. Yearly prescription incidence rates of any AOD and of each specific AOD were calculated as the number of patients first prescribed these AODs per 10,000person-years (py)...
October 11, 2016: Bone
Isla S Mackenzie, Steven V Morant, Li Wei, Alastair M Thompson, Thomas M MacDonald
AIMS: Spironolactone is widely used to treat heart failure, hypertension and liver disease with increased usage in recent years. Spironolactone has endocrine effects that could influence cancer risks and historical reports suggest possible links with increased risk of certain types of cancer. The aim of this study was to assess the effect of spironolactone exposure on cancer incidence. METHODS: A pharmacoepidemiological propensity score-matched cohort study was performed to assess the effect of spironolactone exposure on cancer incidence...
October 13, 2016: British Journal of Clinical Pharmacology
Paraskevas Vezyridis, Stephen Timmons
OBJECTIVE: To identify publication and citation trends, most productive institutions and countries, top journals, most cited articles and authorship networks from articles that used and analysed data from primary care databases (CPRD, THIN, QResearch) of pseudonymised electronic health records (EHRs) in UK. METHODS: Descriptive statistics and scientometric tools were used to analyse a SCOPUS data set of 1891 articles. Open access software was used to extract networks from the data set (Table2Net), visualise and analyse coauthorship networks of scholars and countries (Gephi) and density maps (VOSviewer) of research topics co-occurrence and journal cocitation...
October 11, 2016: BMJ Open
N A Francis, K Entwistle, M Santer, A M Layton, E A Eady, C C Butler
BACKGROUND: Effective management of acne vulgaris in primary care involves support (usually provided over a number of consultations) and prescribing effective treatments. However, consulting and prescribing patterns for acne in primary care are not well described. OBJECTIVE: To describe the rate of primary care consultations and follow-up consultations; prescribing patterns, including overall use of acne related medications (ARM) and initial and follow-up prescribing, for acne vulgaris in the UK...
September 22, 2016: British Journal of Dermatology
N Larivée, S Suissa, M Eberg, L Joseph, M J Eisenberg, H A Abenhaim, K B Filion
OBJECTIVE: To compare the rate of arterial thromboembolism (ATE) of drospirenone-containing COCs to that of levonorgestrel-containing COCs. DESIGN: Population-based cohort study. SETTING: United Kingdom's Clinical Practice Research Datalink (CPRD), which contains clinical records for >11 million patients. POPULATION: Women aged 16-45 years prescribed a drospirenone- or levonorgestrel-containing COC between May 2002 and June 2012...
October 5, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
K Windfuhr, D While, N Kapur, D M Ashcroft, E Kontopantelis, M J Carr, J Shaw, L Appleby, R T Webb
BACKGROUND: Little is known about the precursors of suicide risk among primary-care patients. This study aimed to examine suicide risk in relation to patterns of clinical consultation, psychotropic drug prescribing, and psychiatric diagnoses. METHOD: Nested case-control study in the Clinical Practice Research Datalink (CPRD), England. Patients aged ⩾16 years who died by suicide during 2002-2011 (N = 2384) were matched on gender, age and practice with up to 20 living control patients (N = 46 899)...
September 21, 2016: Psychological Medicine
William Hollingworth, Mousumi Biswas, Rachel L Maishman, Mark J Dayer, Theresa McDonagh, Sarah Purdy, Barnaby C Reeves, Chris A Rogers, Rachael Williams, Maria Pufulete
BACKGROUND: Evidence on the economic impact of heart failure (HF) is vital in order to predict the cost-effectiveness of novel interventions. We estimate the health system costs of HF during the last five years of life. METHODS: We used linked primary care and mortality data accessed through the Clinical Practice Research Datalink (CPRD) to identify 1555 adults in England who died with HF in 2012/13. We used CPRD and linked Hospital Episode Statistics to estimate the cost of medications, primary and hospital healthcare...
September 15, 2016: International Journal of Cardiology
Caroline Fairhurst, Fabiola Martin, Ian Watt, Tim Doran, Martin Bland, William J Brackenbury
INTRODUCTION: Voltage-gated sodium channel (VGSC)-inhibiting drugs are commonly used to treat epilepsy and cardiac arrhythmia. VGSCs are also widely expressed in various cancers, including those of the breast, bowel and prostate. A number of VGSC-inhibiting drugs have been shown to inhibit cancer cell proliferation, invasion, tumour growth and metastasis in preclinical models, suggesting that VGSCs may be novel molecular targets for cancer treatment. Surprisingly, we previously found that prior exposure to VGSC-inhibiting drugs may be associated with reduced overall survival in patients with cancer, but we were unable to control for the cause of death or indication for prescription...
2016: BMJ Open
Kevin Wing, Krishnan Bhaskaran, Liam Smeeth, Tjeerd P van Staa, Olaf H Klungel, Robert F Reynolds, Ian Douglas
OBJECTIVES: We aimed to create a 'multidatabase' algorithm for identification of cholestatic liver injury using multiple linked UK databases, before (1) assessing the improvement in case ascertainment compared to using a single database and (2) developing a new single-database case-definition algorithm, validated against the multidatabase algorithm. DESIGN: Method development for case ascertainment. SETTING: Three UK population-based electronic health record databases: the UK Clinical Practice Research Datalink (CPRD), the UK Hospital Episodes Statistics (HES) database and the UK Office of National Statistics (ONS) mortality database...
2016: BMJ Open
D A Springate, R Parisi, E Kontopantelis, D Reeves, C E M Griffiths, D M Ashcroft
BACKGROUND: The burden of psoriasis across many world regions is high and there is a recognised need to better understand the epidemiology of this common skin disorder. OBJECTIVES: To examine changes in the prevalence and incidence of psoriasis, and mortality rates over a 15 year period. METHODS: Cohort study involving analysis of longitudinal electronic health records between 1999 and 2013 using the UK Clinical Practice Research Datalink (CPRD)...
August 31, 2016: British Journal of Dermatology
C Renzi, G Lyratzopoulos, T Card, T P C Chu, U Macleod, B Rachet
BACKGROUND: More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes. METHODS: Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period...
September 27, 2016: British Journal of Cancer
Seyed Hamidreza Mahmoudpour, Ekaterina Vitalievna Baranova, Patrick C Souverein, Folkert W Asselbergs, Anthonius de Boer, Anke Hilse Maitland-van der Zee
AIM: The aim of the present study was to describe the occurrence and determinants of angiotensin-converting enzyme (ACE) inhibitor (ACEI) intolerance and angioedema (AE) among patients initiating ACEI therapy in a real-world primary care population. METHODS: Two nested case-control studies were conducted in a cohort of 276 977 patients aged ≥45 years initiating ACEIs from 2007 to 2014 in the UK Clinical Practice Research Datalink (CPRD). Cases of AE occurring for the first time during ACEI therapy (n = 416) were matched with AE-free controls (n = 4335) on the duration of ACEI treatment...
August 15, 2016: British Journal of Clinical Pharmacology
Dorota Juszczyk, Judith Charlton, Lisa McDermott, Jamie Soames, Kirin Sultana, Mark Ashworth, Robin Fox, Alastair D Hay, Paul Little, Michael V Moore, Lucy Yardley, A Toby Prevost, Martin C Gulliford
INTRODUCTION: Respiratory tract infections (RTIs) account for about 60% of antibiotics prescribed in primary care. This study aims to test the effectiveness, in a cluster randomised controlled trial, of electronically delivered, multicomponent interventions to reduce unnecessary antibiotic prescribing when patients consult for RTIs in primary care. The research will specifically evaluate the effectiveness of feeding back electronic health records (EHRs) data to general practices. METHODS AND ANALYSIS: 2-arm cluster randomised trial using the EHRs of the Clinical Practice Research Datalink (CPRD)...
2016: BMJ Open
Abigail Tebboth, Sally Lee, Anna Scowcroft, Paula Bingham-Gardiner, Will Spencer, John Bolodeoku, Syed Wasi Hassan
PURPOSE: The majority of people with type 2 diabetes mellitus (T2DM) will develop chronic kidney disease in their lifetime. Because most dipeptidyl peptidase (DPP)-4 inhibitors require dose adjustment in patients with T2DM and renal impairment, we aimed to understand how these treatments are prescribed in UK clinical practice, and to determine whether recommended dose adjustments are being made at initial prescription. METHODS: This retrospective, descriptive cohort study analyzed data from the Clinical Practice Research Datalink (CPRD)...
August 2016: Clinical Therapeutics
G Glover, R Williams, P Heslop, J Oyinola, J Grey
BACKGROUND: People with intellectual disabilities (IDs) die at younger ages than the general population, but nationally representative and internationally comparable mortality data about people with ID, quantifying the extent and pattern of the excess, have not previously been reported for England. METHOD: We used data from the Clinical Practice Research Datalink database for April 2010 to March 2014 (CPRD GOLD September 2015). This source covered several hundred participating general practices comprising roughly 5% of the population of England in the period studied...
August 2, 2016: Journal of Intellectual Disability Research: JIDR
Roy G P J de Jong, Arlene M Gallagher, Emily Herrett, Ad A M Masclee, Maryska L G Janssen-Heijnen, Frank de Vries
PURPOSE: The UK Clinical Practice Research Datalink (CPRD) is increasingly being used by Dutch researchers in epidemiology and pharmacoepidemiology. It is however unclear if the UK CPRD is representative of the Dutch population and whether study results would apply to the Dutch population. Therefore, as first step, our objective was to compare the age and sex distribution of the CPRD with the total Dutch population. METHODS: As a measure of representativeness, the age and sex distribution of the UK CPRD were visually and numerically compared with Dutch census data from the StatLine database of the Dutch National Bureau of Statistics in 2011...
July 27, 2016: Pharmacoepidemiology and Drug Safety
Jessie O Oyinlola, Jennifer Campbell, Antonis A Kousoulis
BACKGROUND: There is currently limited evidence regarding the extent Real World Evidence (RWE) has directly impacted the health and social care systems. The aim of this review is to identify national guidelines or guidances published in England from 2000 onwards which have referenced studies using the governmental primary care data provider the Clinical Practice Research Datalink (CPRD). METHODS: The methodology recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed...
2016: BMC Health Services Research
Tomasz Fundament, Paul R Eldridge, Alexander L Green, Alan L Whone, Rod S Taylor, Adrian C Williams, W M Michael Schuepbach
BACKGROUND: Parkinson's disease (PD) is a debilitating illness associated with considerable impairment of quality of life and substantial costs to health care systems. Deep brain stimulation (DBS) is an established surgical treatment option for some patients with advanced PD. The EARLYSTIM trial has recently demonstrated its clinical benefit also in patients with early motor complications. We sought to evaluate the cost-effectiveness of DBS, compared to best medical therapy (BMT), among PD patients with early onset of motor complications, from a United Kingdom (UK) payer perspective...
2016: PloS One
Corinne Willame, Dominique Rosillon, Julia Zima, Maria-Genalin Angelo, Anke L Stuurman, Hilde Vroling, Rachael Boggon, Eveline M Bunge, Manel Pladevall-Vila, Laurence Baril
To assess the risk of autoimmune disease (AD) in 9-25 year-old women within 1 year after the first AS04-HPV-16/18vaccine dose, a retrospective, observational database cohort study was conducted using CPRD GOLD. From CPRD GOLD four cohorts (65,000 subjects each) were retrieved: 1 exposed female cohort (received ≥1 AS04-HPV-16/18vaccine dose between Sep2008-Aug2010) and 3 unexposed cohorts: historical female (Sep2005-Aug2007), concurrent male, and historical male. Co-primary endpoints were confirmed neuroinflammatory/ophthalmic AD and other AD, secondary endpoints were confirmed individual AD...
July 18, 2016: Human Vaccines & Immunotherapeutics
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