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https://www.readbyqxmd.com/read/28544081/direct-medical-costs-of-severe-hypoglycaemic-events-in-patients-with-type-2-diabetes-in-england-a-retrospective-database-study
#1
Tim Holbrook, Yuexin Tang, Romita Das, R Ravi Shankar, Kaan Tunceli, Jean Williams, Larry Radican, Sarah E Holden, Chris Ll Morgan, James Piercy, Craig J Currie
AIMS: Hypoglycaemia in patients with diabetes can be induced by insulins and sulfonylureas. We assessed the real-world impact of specific monotherapy and combination regimens on hypoglycaemic events requiring hospitalisation and related secondary costs to the English healthcare system. METHODS: This retrospective observational study used the Clinical Practice Research Datalink with linked hospital admission data during 2008-2012. Patients with type 2 diabetes mellitus (T2DM) using antihyperglycaemic agents (AHAs) were assigned to mutually exclusive subgroups (insulin- and non-insulin-containing regimens; treatment groups of interest; age group) based on treatment at index date (date of first AHA prescription)...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28536251/concurrent-use-of-long-acting-bronchodilators-in-copd-and-the-risk-of-adverse-cardiovascular-events
#2
Samy Suissa, Sophie Dell'Aniello, Pierre Ernst
The cardiovascular risk of concurrently using long-acting β2-agonists (LABAs) and anticholinergics (LAMAs) in COPD is uncertain. We assessed the comparative cardiovascular and cerebrovascular safety of adding a second long-acting bronchodilator in patients with COPD.We identified a cohort of COPD patients, new users of LABA or the LAMA tiotropium during 2002-2012, from the UK Clinical Practice Research Datalink. Using high-dimensional propensity scores, each patient adding a second bronchodilator was matched with a patient who remained on monotherapy...
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28533199/clinical-relevance-of-thrombocytosis-in-primary-care-a-prospective-cohort-study-of-cancer-incidence-using-english-electronic-medical-records-and-cancer-registry-data
#3
Sarah Er Bailey, Obioha C Ukoumunne, Elizabeth A Shephard, Willie Hamilton
BACKGROUND: Thrombocytosis (raised platelet count) is an emerging risk marker of cancer, but the association has not been fully explored in a primary care context. AIM: To examine the incidence of cancer in a cohort of patients with thrombocytosis, to determine how clinically useful this risk marker could be in predicting an underlying malignancy. DESIGN AND SETTING: A prospective cohort study using Clinical Practice Research Datalink data from 2000 to 2013...
May 22, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28526656/effects-of-pulmonary-rehabilitation-on-exacerbation-number-and-severity-in-people-with-copd-an-historical-cohort-study-using-electronic-health-records
#4
Elizabeth Moore, Roger Newson, Miland Joshi, Thomas Palmer, Kieran J Rothnie, Sally Singh, Azeem Majeed, Michael Soljak, Jennifer K Quint
BACKGROUND: In previous systematic reviews, predominantly of randomised controlled trials, pulmonary rehabilitation (PR) has been shown to reduce hospital admissions for acute exacerbations of COPD (AECOPD). However, findings have been less consistent for cohort studies. We aimed to compare rates of hospitalized and general practice (GP) treated AECOPD before and after PR. METHODS: Using anonymised data from the Clinical Practice Research Datalink and Hospital Episode Statistics, hospital admissions and GP visits for AECOPD were compared one year before and after PR in patients referred for PR...
May 16, 2017: Chest
https://www.readbyqxmd.com/read/28497594/the-impact-of-regulatory-action-on-the-co-prescribing-of-renin-angiotensin-system-blockers-in-uk-primary-care
#5
Craig Allen, Katherine Donegan
PURPOSE: The aim of this study was to assess the impact of regulatory action taken in June 2014 on the co-prescribing of renin-angiotensin system (RAS) blockers in UK primary care. METHODS: RAS blocker prescriptions, issued between 01/01/2009-30/06/2015, were extracted from the Clinical Practice Research Datalink to estimate the quarterly prevalence (number of patients with at least one co-prescription) and incidence (number of patients first receiving a RAS blocker co-prescription) of co-prescribing...
May 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28495810/management-of-lipid-lowering-therapy-in-patients-with-cardiovascular-events-in-the-uk-a-retrospective-cohort-study
#6
Mark D Danese, Michelle Gleeson, Lucie Kutikova, Robert I Griffiths, Kamlesh Khunti, Sreenivasa Rao Kondapally Seshasai, Kausik K Ray
OBJECTIVES: To describe low-density lipoprotein (LDL) cholesterol management and lipid-lowering treatment patterns in patients with a cardiovascular (CV) event. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records linked with Hospital Episode Statistics data. SETTING: Routine clinical practice in the UK from 2006 to 2012. PARTICIPANTS: Individuals ≥18 years were selected at their first CV-related hospitalisation (first event cohort) if they had received ≥2 lipid-lowering therapy prescriptions within 180 days beforehand...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28494470/comorbid-conditions-delay-diagnosis-of-colorectal-cancer-a-cohort-study-using-electronic-primary-care-records
#7
Luke T A Mounce, Sarah Price, Jose M Valderas, William Hamilton
BACKGROUND: Pre-existing non-cancer conditions may complicate and delay colorectal cancer diagnosis. METHOD: Incident cases (aged ⩾40 years, 2007-2009) with colorectal cancer were identified in the Clinical Practice Research Datalink, UK. Diagnostic interval was defined as time from first symptomatic presentation of colorectal cancer to diagnosis. Comorbid conditions were classified as 'competing demands' (unrelated to colorectal cancer) or 'alternative explanations' (sharing symptoms with colorectal cancer)...
May 11, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28490903/cardiovascular-risks-in-smokers-treated-with-nicotine-replacement-therapy-a-historical-cohort-study
#8
Jens Dollerup, Jørgen Vestbo, Tarita Murray-Thomas, Alan Kaplan, Richard J Martin, Emilio Pizzichini, Marcia M M Pizzichini, Anne Burden, Jessica Martin, David B Price
BACKGROUND: Previous research suggests exposure to nicotine replacement therapy (NRT) may be associated with an increased risk of cardiovascular disease (CVD). METHODS: Using data from the United Kingdom's Clinical Practice Research Datalink, this study aimed to evaluate CVD events and survival among individuals who attempted smoking cessation with the support of NRT compared with those aided by smoking cessation advice only. We studied CVD outcomes over 4 and 52 weeks in 50,214 smokers attempting to quit - 33,476 supported by smoking cessation advice and 16,738 with the support of NRT prescribed by their primary care physician...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28483890/premature-death-among-primary-care-patients-with-a-history-of-self-harm
#9
Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb
PURPOSE: Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves. METHODS: During 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28476151/health-care-resource-use-by-patients-before-and-after-a-diagnosis-of-chronic-fatigue-syndrome-cfs-me-a-clinical-practice-research-datalink-study
#10
Simon M Collin, Inger J Bakken, Irwin Nazareth, Esther Crawley, Peter D White
BACKGROUND: Our aim was to investigate patterns of health care resource use by patients before and after a diagnosis of CFS/ME, as recorded by Clinical Practice Research Datalink (CPRD) GP practices in the UK. METHODS: We used a case-control study design in which patients who had a first recorded diagnosis of CFS/ME during the period 01/01/2001 to 31/12/2013 were matched 1:1 with controls by age, sex, and GP practice. We compared rates of GP consultations, diagnostic tests, prescriptions, referrals, and symptoms between the two groups from 15 years (in adults) or 10 years (in children) before diagnosis to 10 years after diagnosis...
May 5, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28474381/risk-of-cervical-cancer-in-symptomatic-women-aged-%C3%A2-40-in-primary-care-a-case-control-study-using-electronic-records
#11
S Walker, W Hamilton
There are approximately 3,000 new UK diagnoses of cervical cancer annually, with many women presenting symptomatically. We aimed to identify and quantify features of cervical cancer in primary care in a case-control study in the UK. Putative features of cervical cancer were identified, and odd ratios and positive predictive values (PPVs) were calculated. About 1,006 women aged ≥40 years diagnosed with cervical cancer and 4,992 age-, sex- and practice-matched controls were selected from the Clinical Practice Research Datalink...
May 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28469154/risk-of-infections-in-patients-with-gout-a-population-based-cohort-study
#12
B Spaetgens, F de Vries, J H M Driessen, H G Leufkens, P C Souverein, A Boonen, J W M van der Meer, L A B Joosten
To investigate the risk of various types of infections (pneumonia and urinary tract infection (UTI)), and infection-related mortality in patients with gout compared with population-based controls. A retrospective cohort study was conducted using data from the UK Clinical Practice Research Datalink (CPRD). All patients with a first diagnosis of gout and aged >40 years between January 1987-July 2014, were included and matched with up to two controls. Time-varying Cox proportional hazards models were used to estimate the risk of infections and mortality...
May 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28463961/herpes-zoster-risk-after-21-specific-cancers-population-based-case-control-study
#13
Erik Hansson, Harriet J Forbes, Sinéad M Langan, Liam Smeeth, Krishnan Bhaskaran
BACKGROUND: Some malignancies are known to be associated with increased risk of herpes zoster, but little is known about how associations between cancer and subsequent zoster risk vary by cancer site, by time since cancer diagnosis, and by age. METHODS: An age-, sex-, calendar time-, and practice-matched case-control study, nested in the broadly UK representative Clinical Practice Research Datalink (CPRD) primary care database, was analysed using conditional logistic regression to estimate the association between 21 of the most common specific malignancies and subsequent zoster risk...
May 2, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28460637/risk-factors-for-developing-acute-kidney-injury-in-older-people-with-diabetes-and-community-acquired-pneumonia-a-population-based-uk-cohort-study
#14
Anu Jain, Helen I McDonald, Dorothea Nitsch, Laurie Tomlinson, Sara L Thomas
BACKGROUND: Acute kidney injury (AKI) is being increasingly recognised in ageing populations. There are a paucity of data about AKI risk factors among older individuals with diabetes and infections, who are at particularly high risk of AKI. The objective of this study was to evaluate the risk factors for developing acute kidney injury (AKI) amongst older patients with diabetes and community-acquired pneumonia (CAP) in England, and whether the impact of underlying kidney function varied with age...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28460603/prevalence-and-patterns-of-antidepressant-switching-amongst-primary-care-patients-in-the-uk
#15
Becky Mars, Jon Heron, David Gunnell, Richard M Martin, Kyla H Thomas, David Kessler
OBJECTIVE: Non-response to antidepressant treatment is a substantial problem in primary care, and many patients with depression require additional second-line treatments. This study aimed to examine the prevalence and patterns of antidepressant switching in the UK, and identify associated demographic and clinical factors. METHOD: Cohort analysis of antidepressant prescribing data from the Clinical Practice Research Datalink, a large, anonymised UK primary care database...
May 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28455344/temporal-trends-in-incidence-prevalence-and-mortality-of-atrial-fibrillation-in-primary-care
#16
Deirdre A Lane, Flemming Skjøth, Gregory Y H Lip, Torben B Larsen, Dipak Kotecha
BACKGROUND: Incidence and prevalence of atrial fibrillation (AF) are expected to increase dramatically; however, we currently lack comprehensive data on temporal trends in unselected clinical populations. METHODS AND RESULTS: Analysis of the UK Clinical Practice Research Datalink (CPRD) from 1998 to 2010 of patients with incident AF, excluding major valvular disease, linked to hospital admission data and national statistics. Fifty-seven thousand eight hundred eighteen adults were identified with mean age 74...
April 28, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28453767/the-pattern-of-underlying-cause-of-death-in-patients-with-inflammatory-bowel-disease-in-england-a-record-linkage-study
#17
Thomas P C Chu, Gordon W Moran, Timothy R Card
Background and Aims: Numerous studies have established that mortality risk in inflammatory bowel disease [IBD] patients is higher than in the general population, but the causes of death have seldom been examined. We aimed to describe causes of death in IBD. Methods: A matched cohort study using UK general practice data from Clinical Practice Research Datalink linked to death registration records. We described the distribution of causes of death among IBD patients by age at death and time since IBD diagnosis...
May 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28451867/prevalence-and-incidence-trends-for-diagnosed-prescription-opioid-use-disorders-in-the-united-kingdom
#18
Andrew J M Cooper, Jenna Willis, Janice Fuller, Heike Benecke, James Leighton-Scott, Frank Andersohn, Joseph Kim, Christoph Maier, Roger D Knaggs
INTRODUCTION: The prevalence of prescription opioid use disorders in the US has increased markedly in parallel with increases in opioid prescribing. Whilst an increase in opioid prescribing has also occurred in the UK, it remains unknown if there have been concurrent increases in opioid use disorders. The aim of this study was to examine national trends in the prevalence and incidence of physician-diagnosed opioid use disorders in the UK. METHODS: In a retrospective electronic health care database analysis using data from the UK Clinical Practice Research Datalink (CPRD), we identified persons receiving a first opioid prescription between January 1, 2008 and December 31, 2012...
April 27, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28449686/the-frequency-of-asthma-exacerbations-and-healthcare-utilization-in-patients-with-asthma-from-the-uk-and-usa
#19
Robert Y Suruki, Jonas B Daugherty, Nada Boudiaf, Frank C Albers
BACKGROUND: Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. METHODS: Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date)...
April 27, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28441696/declining-blood-pressure-and-intensification-of-blood-pressure-management-among-people-over-80-years-cohort-study-using-electronic-health-records
#20
Rathi Ravindrarajah, Alex Dregan, Nisha C Hazra, Shota Hamada, Stephen H D Jackson, Martin C Gulliford
BACKGROUND: Management of high blood pressure (BP) in people over 80 years is controversial, but there is limited information available concerning the uptake of hypertension treatment at this age. OBJECTIVE: To evaluate use of antihypertensive drugs and changes in SBP and DBP from 2001 to 2014 in men and women aged 80 years and over. METHODS: Cohort study using primary care electronic health records of 265 225 participants from the UK Clinical Practice Research Datalink...
June 2017: Journal of Hypertension
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