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clinical practice research datalink

Julia Granerod, Nicholas W S Davies, Parashar P Ramanuj, Ava Easton, David W G Brown, Sara L Thomas
The true extent of sequelae in encephalitis survivors relative to rates within the general population is not known. This study aimed to quantify increased risks of epilepsy, depressive disorders, anxiety disorders, psychotic disorders, bipolar disorder, cognitive problems, dementia, headache, and alcohol abuse among encephalitis cases. 2460 exposed individuals diagnosed with incident encephalitis in the Clinical Practice Research Datalink and 47,914 unexposed individuals without a history of encephalitis were included...
October 20, 2016: Journal of Neurology
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
Robert Morlock, Pierre Chevalier, Laura Horne, Javier Nuevo, Chris Storgard, Lalitha Aiyer, Dionne M Hines, Xavier Ansolabehere, Fredrik Nyberg
INTRODUCTION: The present study aimed to assess disease control, health resource utilization (HRU), and healthcare costs, and their predictors in gout patients across the USA, UK, Germany, and France. METHODS: Data were extracted from the PharMetrics Plus (USA), Clinical Practice Research Datalink-Hospital Episode Statistics (UK), and Disease Analyzer databases (Germany and France) for adult gout patients over a 3-year period: 2009-2011 (all dates +1 year for France)...
June 2016: Rheumatol Ther
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
Lamiece Hassan, Jane Senior, Roger T Webb, Martin Frisher, Mary P Tully, David While, Jenny J Shaw
BACKGROUND: Mental illness is highly prevalent among prisoners. Although psychotropic medicines can ameliorate symptoms of mental illness, prescribers in prisons must balance clinical needs against risks to safety and security. Concerns have been raised at the large number of prisoners reportedly receiving psychotropic medicines in England. Nonetheless, unlike for the wider community, robust prescribing data are not routinely available for prisons. We investigated gender-specific patterns in the prevalence and appropriateness of psychotropic prescribing in English prisons...
October 10, 2016: BMC Psychiatry
C Klop, T P van Staa, C Cooper, N C Harvey, F de Vries
: One-year mortality following a fracture was greater for men compared to women, varied markedly between regions in England with the lowest rates in the London region, and was higher among black women compared to white women. The excess in mortality did not change during the study period. INTRODUCTION: Fractures are associated with increased mortality. With the shift towards an increasingly elderly demography, and so increasing numbers of fractures, the impact of such events on mortality is of key public health importance...
October 8, 2016: Osteoporosis International
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
Alexander T Cohen, Anja Katholing, Stephan Rietbrock, Luke Bamber, Carlos Martinez
Population studies on the incidence of venous thromboembolism (VTE) in patients with active cancer are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The source population consisted of all patients in the UK Clinical Practice Research Datalink, with additional information on hospitalisation and cause of death, between 2001 and 2011. A cancer-related clinical diagnosis or therapy within the 90 days before or after a VTE constituted an active-cancer-associated VTE...
October 6, 2016: Thrombosis and Haemostasis
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
Paul Brassard, Jennifer W Wu, Pierre Ernst, Sophie Dell'Aniello, Brielan Smiechowski, Samy Suissa
PURPOSE: The effect of statins on cytokine-mediated inflammatory responses may impact on the prognosis of influenza. We assessed whether statin use decreases the incidence of adverse influenza-related outcomes. Additionally, we used a new-user study design to minimize healthy user bias. We further examined the possibility of non-causal associations by using unrelated outcomes. METHODS: We used the UK Clinical Practice Research Datalink to identify all patients aged 30 or older diagnosed with influenza-like illness during 1997-2010...
September 30, 2016: Pharmacoepidemiology and Drug Safety
Michelle E Johnson, Cinira Lefèvre, Shuk-Li Collings, David Evans, Sebastian Kloss, Essra Ridha, Andrew Maguire
OBJECTIVES: To examine the characteristics and persistence in patients newly initiated with oral anticoagulants (OACs) for stroke prevention in non-valvular atrial fibrillation (NVAF). DESIGN: Cohort study in Clinical Practice Research Datalink. SETTING: UK primary care. PARTICIPANTS: 15 242 patients with NVAF newly prescribed apixaban, rivaroxaban, dabigatran or vitamin K antagonists (VKAs) between 1 December 2012 and 31 October 2014...
September 26, 2016: BMJ Open
Julia Spoendlin, J Bradley Layton, Mallika Mundkur, Christian Meier, Susan S Jick, Christoph R Meier
INTRODUCTION: Case reports and pharmacovigilance data reported cases of tendon ruptures in statin users, but evidence from observational studies is scarce and inconclusive. We aimed to assess the association between new statin use and tendon rupture. METHODS: We performed a propensity score (PS)-matched sequential cohort study, using data from the Clinical Practice Research Datalink. Patients aged ≥45 years with at least one new statin prescription between 1995 and 2014 were PS-matched within 2-year entry blocks to patients without a statin prescription during the block...
September 27, 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Katrina Wilcox Hagberg, Hozefa A Divan, Rebecca Persson, J Curtis Nickel, Susan S Jick
OBJECTIVE:  To estimate the risk of erectile dysfunction in men who used 5-α reductase inhibitors to treat benign prostatic hyperplasia or alopecia. DESIGN:  Cohort studies with nested case-control analyses. SETTING:  UK Clinical Practice Research Datalink. POPULATION:  Two populations of men free of risk factors for erectile dysfunction and other sexual dysfunction or its treatment: men aged 40 or more with benign prostatic hyperplasia who received a prescription for a 5-α reductase inhibitor (finasteride or dutasteride) or α blocker, or both, and men aged 18-59 with alopecia...
2016: BMJ: British Medical Journal
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
Preeti Datta-Nemdharry, Andrew Thomson, Julie Beynon, Katherine Donegan
PURPOSE: The purpose of this study is to characterise how Type 2 Diabetes Mellitus (T2DM) is treated in England and Wales and whether this adheres to 2009 National Institute for Health and Care Excellence (NICE) guidance on management of T2DM. METHODS: Data for T2DM patients aged 18+ years prescribed at least one anti-diabetic drug between 01/01/2000-30/06/2012 were extracted from the Clinical Practice Research Datalink. We examined the sequences in which anti-diabetic drugs were prescribed and, for patients on the most common anti-diabetic drug pathways, evaluated average HbA1c values at treatment initiation and at progression to a second or third-line anti-diabetic drug class, including insulin...
September 19, 2016: Pharmacoepidemiology and Drug Safety
Isaac Barker, Therese Lloyd, Adam Steventon
OBJECTIVE: To assess the effect of introducing named accountable general practitioners (GPs) for patients aged 75 years on patterns of general practice utilisation, including continuity of care. DESIGN: Regression discontinuity design applied to data from the Clinical Practice Research Datalink to estimate the treatment effect for compliers aged 75. SETTING: 200 general practices in England. PARTICIPANTS: 255 469 patients aged between 65 and 85, after excluding those aged 75...
September 16, 2016: BMJ Open
Sophie V Eastwood, Rohini Mathur, Mark Atkinson, Sinead Brophy, Cathie Sudlow, Robin Flaig, Simon de Lusignan, Naomi Allen, Nishi Chaturvedi
OBJECTIVES: UK Biobank is a UK-wide cohort of 502,655 people aged 40-69, recruited from National Health Service registrants between 2006-10, with healthcare data linkage. Type 2 diabetes is a key exposure and outcome. We developed algorithms to define prevalent and incident diabetes for UK Biobank. The algorithms will be implemented by UK Biobank and their results made available to researchers on request. METHODS: We used UK Biobank self-reported medical history and medication to assign prevalent diabetes and type, and tested this against linked primary and secondary care data in Welsh UK Biobank participants...
2016: PloS One
Samy Suissa, Erica E M Moodie, Sophie Dell'Aniello
PURPOSE: Studies of the real-world comparative effectiveness of drugs conducted using computerized healthcare databases typically involve an incident new-user cohort design for head-to-head comparisons between two medications, using exclusively treatment-naïve patients. However, the desired contrast often involves one new drug compared with an older drug, of which many users of the new drug may have switched from, seriously restricting the scope of incident new-user studies. METHODS: We introduce prevalent new-user cohort designs for head-to-head comparative drug effect studies, where incident new users are scarce...
September 9, 2016: Pharmacoepidemiology and Drug Safety
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