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https://www.readbyqxmd.com/read/28218819/healthcare-resource-utilization-and-related-financial-costs-associated-with-glucose-lowering-with-either-exenatide-or-basal-insulin-a-retrospective-cohort-study
#1
Sarah E Holden, Christopher Ll Morgan, Qing Qiao, Sara Jenkins-Jones, Ellen R Berni, Craig J Currie
AIMS: Type 2 diabetes is a major health problem placing increasing demands on healthcare systems. Our objective was to estimate healthcare resource use and related financial costs following treatment with exenatide-based regimens prescribed as once-weekly (EQW) or twice-daily (EBID) formulations, compared with regimens based on basal insulin (BI). MATERIALS AND METHODS: This retrospective cohort study used data from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES)...
February 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28209371/the-effect-of-patient-age-at-intervention-on-risk-of-implant-revision-after-total-replacement-of-the-hip-or-knee-a-population-based-cohort-study
#2
Lee E Bayliss, David Culliford, A Paul Monk, Sion Glyn-Jones, Daniel Prieto-Alhambra, Andrew Judge, Cyrus Cooper, Andrew J Carr, Nigel K Arden, David J Beard, Andrew J Price
BACKGROUND: Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery. METHODS: We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement...
February 13, 2017: Lancet
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#3
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28202399/the-epidemiology-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-in-the-uk
#4
Noel Frey, Janine Jossi, Michael Bodmer, Andreas Bircher, Susan S Jick, Christoph R Meier, Julia Spoendlin
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening mucocutaneous diseases. SJS/TEN mostly manifest as a reaction to new drug use, but little is known about their incidence and epidemiology. We conducted a large observational study on the epidemiology of SJS/TEN using data from the UK-based Clinical Practice Research Datalink. Among 551 validated SJS/TEN cases, we calculated an incidence rate of 5.76 SJS/TEN cases/million person-years between 1995 and 2013, which was consistent throughout the study period, and was highest in patients aged 1-10 years and ≥80 years...
February 12, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28199787/prolactin-elevating-antipsychotics-and-the-risk-of-endometrial-cancer
#5
Adi J Klil-Drori, Hui Yin, Haim A Abenhaim, Guillaume Galbaud du Fort, Laurent Azoulay
BACKGROUND: The use of antipsychotics may increase the risk of endometrial cancer through elevation of prolactin levels. We investigated the association between antipsychotics that are known to cause prolactin elevation and the risk of endometrial cancer. METHODS: In data from the United Kingdom Clinical Practice Research Datalink, all women who were newly treated with antipsychotics from 1990-2013 were identified and followed until 2014. Within this cohort of antipsychotic users, a nested case-control analysis was conducted...
February 14, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28196724/persistence-and-adherence-with-mirabegron-versus-antimuscarinic-agents-in-patients-with-overactive-bladder-a-retrospective-observational-study-in-uk-clinical-practice
#6
Christopher R Chapple, Jameel Nazir, Zalmai Hakimi, Sally Bowditch, Francis Fatoye, Florent Guelfucci, Amine Khemiri, Emad Siddiqui, Adrian Wagg
BACKGROUND: Persistence with antimuscarinic therapy in overactive bladder (OAB) is poor, but may be different for mirabegron, a β3-adrenoceptor agonist with a different adverse event profile. OBJECTIVE: To compare persistence and adherence with mirabegron versus tolterodine extended release (ER) and other antimuscarinics in routine clinical practice over a 12-mo period. DESIGN, SETTING, AND PARTICIPANTS: Retrospective, longitudinal, observational study of anonymised data from the UK Clinical Practice Research Datalink GOLD database...
February 11, 2017: European Urology
https://www.readbyqxmd.com/read/28188601/sensitivity-of-the-uk-clinical-practice-research-datalink-to-detect-neurodevelopmental-effects-of-medicine-exposure-in-utero-comparative-analysis-of-an-antiepileptic-drug-exposed-cohort
#7
R A Charlton, A McGrogan, J Snowball, L M Yates, A Wood, J Clayton-Smith, W H Smithson, J L Richardson, N McHugh, S H L Thomas, G A Baker, R Bromley
INTRODUCTION: Electronic healthcare data have several advantages over prospective observational studies, but the sensitivity of data on neurodevelopmental outcomes and its comparability with data generated through other methodologies is unknown. OBJECTIVES: The objectives of this study were to determine whether data from the UK Clinical Practice Research Datalink (CPRD) produces similar risk estimates to a prospective cohort study in relation to the risk of neurodevelopmental disorders (NDDs) following prenatal antiepileptic drug (AED) exposure...
February 10, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28176886/assessment-of-channeling-bias-among-initiators-of-glucose-lowering-drugs-a-uk-cohort-study
#8
Mikkel Z Ankarfeldt, Brian L Thorsted, Rolf Hh Groenwold, Erpur Adalsteinsson, M Sanni Ali, Olaf H Klungel
BACKGROUND: Channeling bias may occur when a newly marketed drug and an established drug, despite similar indications, are prescribed to patients with different prognostic characteristics (ie, confounding). AIM: To investigate channeling bias and its impact on relative effectiveness of glucagon-like peptide-1 (GLP-1) analogs versus basal insulin and dipeptidyl peptidase-4 inhibitors (DPP-4i) versus sulfonylurea. METHODS: In the UK Clinical Practice Research Datalink, patients with type 2 diabetes initiating treatment between 2006 and 2015 were included...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28173634/prevalence-glucose-control-and-relative-survival-of-people-with-type-2-diabetes-in-the-uk-from-1991-to-2013
#9
S E Holden, S Jenkins-Jones, C Ll Morgan, J R Peters, G Schernthaner, C J Currie
AIMS: To characterize the prevalence of Type 2 diabetes between 1991 and 2013 in the UK and to determine whether corresponding glucose control and survival had changed in the diabetic population during this period. METHODS: For this retrospective cohort study, people diagnosed with Type 2 diabetes between 1991 and 2013 were identified from the Clinical Practice Research Datalink (CPRD) and the point prevalence calculated. Mean HbA1c by year was estimated. The Cox proportional hazards model was used to calculate the risk of all-cause mortality by year for incident cases of Type 2 diabetes treated with glucose-lowering therapy...
February 7, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28156036/assessing-recording-delays-in-general-practice-records-to-inform-near-real-time-vaccine-safety-surveillance-using-the-clinical-practice-research-datalink-cprd
#10
Andreia Leite, Nick J Andrews, Sara L Thomas
PURPOSE: Near real-time vaccine safety surveillance (NRTVSS) is an option for post-licensure vaccine safety assessment. NRTVSS requires timely recording of outcomes in the database used. Our main objective was to examine recording delays in the Clinical Practice Research Datalink (CPRD) for outcomes of interest for vaccine safety to inform the feasibility of NRTVSS using these data. We also evaluated completeness of recording and further assessed reporting delays for hospitalized events in CPRD...
February 3, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28148478/association-between-continuity-of-care-in-general-practice-and-hospital-admissions-for-ambulatory-care-sensitive-conditions-cross-sectional-study-of-routinely-collected-person-level-data
#11
Isaac Barker, Adam Steventon, Sarah R Deeny
OBJECTIVE:  To assess whether continuity of care with a general practitioner is associated with hospital admissions for ambulatory care sensitive conditions for older patients. DESIGN:  Cross sectional study. SETTING:  Linked primary and secondary care records from 200 general practices participating in the Clinical Practice Research Datalink in England. PARTICIPANTS:  230 472 patients aged between 62 and 82 years and who experienced at least two contacts with a general practitioner between April 2011 and March 2013...
February 1, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28130603/linked-hospital-and-primary-care-database-analysis-of-the-impact-of-short-term-complications-on-recurrence-in-laparoscopic-inguinal-hernia-repair
#12
G Bouras, E M Burns, A M Howell, A Bottle, T Athanasiou, A Darzi
OBJECTIVE: To study the effects of short-term complications on recurrence following laparoscopic inguinal hernia repair using routine data. BACKGROUND: Linked primary and secondary care databases can evaluate the quality of inguinal hernia surgery by quantifying short- and long-term outcome together. METHODS: Longitudinal analysis of linked primary care (Clinical Practice Research Datalink) and hospital administrative (Hospital Episodes Statistics) databases quantified 30-day complications (wound infection and bleeding) and surgery for recurrence after primary repair performed between 1st April 1997 and 31st March 2012...
January 27, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28126029/respiratory-effect-of-beta-blockers-in-people-with-asthma-and-cardiovascular-disease-population-based-nested-case-control-study
#13
Daniel R Morales, Brian J Lipworth, Peter T Donnan, Cathy Jackson, Bruce Guthrie
BACKGROUND: Cardiovascular disease (CVD) is a common comorbidity in people with asthma. However, safety concerns have caused heterogeneity in clinical guideline recommendations over the use of cardioselective beta-blockers in people with asthma and CVD, partly because risk in the general population has been poorly quantified. The aim of this study was to measure the risk of asthma exacerbations with beta-blockers prescribed to a general population with asthma and CVD. METHODS: Linked data from the UK Clinical Practice Research Datalink was used to perform nested case-control studies among people with asthma and CVD matched on age, sex and calendar time...
January 27, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28122831/quality-of-recording-of-diabetes-in-the-uk-how-does-the-gp-s-method-of-coding-clinical-data-affect-incidence-estimates-cross-sectional-study-using-the-cprd-database
#14
A Rosemary Tate, Sheena Dungey, Simon Glew, Natalia Beloff, Rachael Williams, Tim Williams
OBJECTIVE: To assess the effect of coding quality on estimates of the incidence of diabetes in the UK between 1995 and 2014. DESIGN: A cross-sectional analysis examining diabetes coding from 1995 to 2014 and how the choice of codes (diagnosis codes vs codes which suggest diagnosis) and quality of coding affect estimated incidence. SETTING: Routine primary care data from 684 practices contributing to the UK Clinical Practice Research Datalink (data contributed from Vision (INPS) practices)...
January 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28115334/risk-of-cardiovascular-events-arrhythmia-and-all-cause-mortality-associated-with-clarithromycin-versus-alternative-antibiotics-prescribed-for-respiratory-tract-infections-a-retrospective-cohort-study
#15
Ellen Berni, Hanka de Voogd, Julian P Halcox, Christopher C Butler, Christian A Bannister, Sara Jenkins-Jones, Bethan Jones, Mario Ouwens, Craig J Currie
OBJECTIVE: To determine whether treatment with clarithromycin for respiratory tract infections was associated with an increased risk of cardiovascular (CV) events, arrhythmias or all-cause mortality compared with other antibiotics. DESIGN: Retrospective cohort design comparing clarithromycin monotherapy for lower (LRTI) or upper respiratory tract infection (URTI) with other antibiotic monotherapies for the same indication. SETTING: Routine primary care data from the UK Clinical Practice Research Datalink and inpatient data from the Hospital Episode Statistics (HES)...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110382/economic-evaluations-alongside-efficient-study-designs-using-large-observational-datasets-the-pleasant-trial-case-study
#16
Matthew Franklin, Sarah Davis, Michelle Horspool, Wei Sun Kua, Steven Julious
BACKGROUND: Large observational datasets such as Clinical Practice Research Datalink (CPRD) provide opportunities to conduct clinical studies and economic evaluations with efficient designs. OBJECTIVES: Our objectives were to report the economic evaluation methodology for a cluster randomised controlled trial (RCT) of a UK NHS-delivered public health intervention for children with asthma that was evaluated using CPRD and describe the impact of this methodology on results...
January 21, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28106922/recurrence-risk-of-venous-thromboembolism-and-hormone-use-in-women-from-england-a-cohort-study-using-clinical-practice-research-datalink
#17
Sylvia Kiconco, Alyshah Abdul Sultan, Matthew J Grainge
It is vital to identify people with low recurrence risk of venous thromboembolism (VTE) so as to protect them from dangers of prolonged anticoagulation therapy. Among women who develop VTE following hormone use, the evidence as to whether their risk of recurrence is low if they cease this therapy is conflicting. We investigated whether women whose initial VTE event was hormone-related have a lower risk of VTE recurrence than women whose initial event had no obvious cause (unprovoked). A cohort study utilising the Clinical Practice Research Datalink linked to Hospital Episode Statistics data from England was conducted...
January 20, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#18
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into four cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (n = 1448), acute coronary syndrome (ACS) (n = 602), ischemic stroke (IS) (n = 151), and heart failure (HF) (n = 291) incident cohorts...
January 25, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28077689/giant-cell-arteritis-and-vascular-disease-risk-factors-and-outcomes-a-cohort-study-using-uk-clinical-practice-research-datalink
#19
Lin Li, Tuhina Neogi, Susan Jick
OBJECTIVE: To evaluate the associations between GCA and vascular diseases and other comorbidities in patients with GCA compared with non-vasculitis patients. METHODS: Using the UK-based Clinical Practice Research Datalink we identified 9778 newly diagnosed GCA patients in 1990-2014, and up to 10 non-vasculitis patients randomly matched to each case on age, sex, practice and years of history before cohort entry. We compared the distributions of 9 different pre-existing vascular diseases and 11 other comorbidities, and risks of incident vascular diseases and other comorbidities after cohort entry between GCA and non-vasculitis patients...
January 11, 2017: Rheumatology
https://www.readbyqxmd.com/read/28069618/adherence-to-guidelines-for-creatinine-and-potassium-monitoring-and-discontinuation-following-renin-angiotensin-system-blockade-a-uk-general-practice-based-cohort-study
#20
Morten Schmidt, Kathryn E Mansfield, Krishnan Bhaskaran, Dorothea Nitsch, Henrik Toft Sørensen, Liam Smeeth, Laurie A Tomlinson
OBJECTIVES: To examine adherence to serum creatinine and potassium monitoring and discontinuation guidelines following initiation of treatment with ACE inhibitors (ACEI) or angiotensin receptor blockers (ARBs); and whether high-risk patients are monitored. DESIGN: A general practice-based cohort study using electronic health records from the UK Clinical Practice Research Datalink and Hospital Episode Statistics. SETTING: UK primary care, 2004-2014...
January 9, 2017: BMJ Open
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