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https://www.readbyqxmd.com/read/29442611/relative-toxicity-of-benzodiazepines-and-hypnotics-commonly-used-for-self-poisoning-an-epidemiological-study-of-fatal-toxicity-and-case-fatality
#1
Galit Geulayov, Anne Ferrey, Deborah Casey, Claudia Wells, Alice Fuller, Clare Bankhead, David Gunnell, Caroline Clements, Navneet Kapur, Jennifer Ness, Keith Waters, Keith Hawton
The relative toxicity of anxiolytic and hypnotic drugs commonly used for self-poisoning was assessed using data on suicides, prescriptions and non-fatal self-poisonings in England, 2005-2012. Data on suicide by self-poisoning were obtained from the Office for National Statistics, information on intentional non-fatal self-poisoning was derived from the Multicentre Study of Self-harm in England and data on prescriptions in general practice from the Clinical Practice Research Datalink. We used two indices of relative toxicity: fatal toxicity (the number of fatal self-poisonings relative to the number of individuals prescribed each drug) and case fatality (the number of fatal relative to non-fatal self-poisonings)...
February 1, 2018: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29438980/trimethoprim-use-for-urinary-tract-infection-and-risk-of-adverse-outcomes-in-older-patients-cohort-study
#2
Elizabeth Crellin, Kathryn E Mansfield, Clémence Leyrat, Dorothea Nitsch, Ian J Douglas, Adrian Root, Elizabeth Williamson, Liam Smeeth, Laurie A Tomlinson
OBJECTIVE: To determine if trimethoprim use for urinary tract infection (UTI) is associated with an increased risk of acute kidney injury, hyperkalaemia, or sudden death in the general population. DESIGN: Cohort study. SETTING: UK electronic primary care records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database. PARTICIPANTS: Adults aged 65 and over with a prescription for trimethoprim, amoxicillin, cefalexin, ciprofloxacin, or nitrofurantoin prescribed up to three days after a primary care diagnosis of UTI between April 1997 and September 2015...
February 9, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29430198/acute-kidney-injury-and-infections-in-patients-taking-antihypertensive-drugs-a-self-controlled-case-series-analysis
#3
Kathryn E Mansfield, Ian J Douglas, Dorothea Nitsch, Sara L Thomas, Liam Smeeth, Laurie A Tomlinson
Background: The relative risk of acute kidney injury (AKI) following different infections, and whether angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) modify the risk, is unclear. We aimed to determine the risks of hospital admission with AKI following infections (urinary tract infection [UTI], lower respiratory tract infection [LRTI], and gastroenteritis) among users of antihypertensive drugs. Methods: We used UK electronic health records from practices contributing to the Clinical Practice Research Datalink linked to the Hospital Episode Statistics database...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29409137/mortality-in-patients-with-giant-cell-arteritis-a-cohort-study-in-uk-primary-care
#4
Lin Li, Tuhina Neogi, Susan Jick
OBJECTIVE: To examine whether giant cell arteritis (GCA) is associated with increased all-cause mortality and whether mortality differs according to age, sex, and calendar year of cohort entry. METHODS: Using the UK-based Clinical Practice Research Datalink we identified 9778 newly diagnosed GCA patients from 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 used Cox regression to estimate adjusted hazard ratios (HRs) for mortality of GCA patients in comparison to non-vasculitis patients, then stratified by age, sex, and calendar year of cohort entry...
February 6, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29397000/estimating-the-healthcare-costs-of-children-born-to-pregnant-smokers-in-england-cohort-study-using-primary-and-secondary-healthcare-data
#5
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
https://www.readbyqxmd.com/read/29394190/post-diagnostic-calcium-channel-blocker-use-and-breast-cancer-mortality-a-population-based-cohort-study
#6
John Busby, Ken Mills, Shu-Dong Zhang, Fabio Giuseppe Liberante, Chris Cardwell
BACKGROUND: There have long been concerns that calcium channel blockers (CCBs), widely used to treat hypertension, may contribute to malignant growth through the evasion of apoptosis and proliferation of cancer cells. Worryingly, a recent cohort study found breast cancer patients who used CCBs had higher death rates, but interpreting these results was difficult as they were based on all-cause mortality and medication use before cancer diagnosis. We used UK population-based data to more robustly investigate the association between CCB use and cancer-specific mortality...
February 1, 2018: Epidemiology
https://www.readbyqxmd.com/read/29391833/a-validation-study-of-the-circom-comorbidity-score-in-an-english-cirrhosis-population-using-the-clinical-practice-research-datalink
#7
Colin J Crooks, Joe West, Peter Jepsen
Purpose: The CirCom score has been developed from Danish data as a specific measure of comorbidity for cirrhosis to predict all-cause mortality. We compared its performance with the Charlson Comorbidity Index (CCI) in an English cirrhosis population. Patients and methods: We used comorbidity scores in a survival model to predict mortality in a cirrhosis cohort in the Clinical Practice Research Datalink. The discrimination of each score was compared by age, gender, socioeconomic status, cirrhosis etiology, cirrhosis stage, and year after cirrhosis diagnosis...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29391368/predicting-prostate-cancer-progression-protocol-for-a-retrospective-cohort-study-to-identify-prognostic-factors-for-prostate-cancer-outcomes-using-routine-primary-care-data
#8
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
https://www.readbyqxmd.com/read/29389968/inferring-pregnancy-episodes-and-outcomes-within-a-network-of-observational-databases
#9
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
https://www.readbyqxmd.com/read/29388189/inequalities-in-zoster-disease-burden-a-population-based-cohort-study-to-identify-social-determinants-using-linked-data-from-the-uk-clinical-practice-research-datalink
#10
A Jain, A J van Hoek, J L Walker, H J Forbes, S M Langan, A Root, L Smeeth, S L Thomas
BACKGROUND: Zoster vaccination was introduced in England in 2013, where tackling health inequalities is a statutory requirement. However, specific population groups with higher zoster burden remain largely unidentified. OBJECTIVE: To evaluate health inequalities in zoster disease burden prior to zoster vaccine introduction in England. METHODS: This population-based cohort study utilised anonymised UK primary care data linked to hospitalisation and deprivation data...
February 1, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29386666/cataract-in-patients-with-diabetes-mellitus-incidence-rates-in-the-uk-and-risk-factors
#11
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
https://www.readbyqxmd.com/read/29386249/precision-medicine-in-type-2-diabetes-clinical-markers-of-insulin-resistance-are-associated-with-altered-short-and-long-term-glycemic-response-to-dpp-4-inhibitor-therapy
#12
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
https://www.readbyqxmd.com/read/29386248/trends-in-hospital-admission-for-diabetic-ketoacidosis-in-adults-with-type-1-and-type-2-diabetes-in-england-1998-2013-a-retrospective-cohort-study
#13
Victor W Zhong, Juhaeri Juhaeri, Elizabeth J Mayer-Davis
OBJECTIVE: This study determined trends in hospital admission for diabetic ketoacidosis (DKA) in adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) from 1998 to 2013 in England. RESEARCH DESIGN AND METHODS: The study population included 23,246 adults with T1DM and 241,441 adults with T2DM from the Clinical Practice Research Datalink and Hospital Episode Statistics. All hospital admissions for DKA as the primary diagnosis from 1998 to 2013 were identified...
January 31, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29378699/use-of-primary-care-data-to-predict-those-most-vulnerable-to-cold-weather-a-case-crossover-analysis
#14
Peter Tammes, Claudio Sartini, Ian Preston, Alastair D Hay, Daniel Lasserson, Richard W Morris
BACKGROUND: The National Institute for Health and Care Excellence (NICE) recommends that GPs use routinely available data to identify patients most at risk of death and ill health from living in cold homes. AIM: To investigate whether sociodemographic characteristics, clinical factors, and house energy efficiency characteristics could predict cold-related mortality. DESIGN AND SETTING: A case-crossover analysis was conducted on 34 777 patients aged ≥65 years from the Clinical Practice Research Datalink who died between April 2012 and March 2014...
January 29, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29374669/trends-and-determinants-of-length-of-stay-and-hospital-reimbursement-following-knee-and-hip-replacement-evidence-from-linked-primary-care-and-nhs-hospital-records-from-1997-to-2014
#15
Edward Burn, Christopher J Edwards, David W Murray, Alan Silman, Cyrus Cooper, Nigel K Arden, Rafael Pinedo-Villanueva, Daniel Prieto-Alhambra
OBJECTIVES: To measure changes in length of stay following total knee and hip replacement (TKR and THR) between 1997 and 2014 and estimate the impact on hospital reimbursement, all else being equal. Further, to assess the degree to which observed trends can be explained by improved efficiency or changes in patient profiles. DESIGN: Cross-sectional study using routinely collected data. SETTING: National Health Service primary care records from 1995 to 2014 in the Clinical Practice Research Datalink were linked to hospital inpatient data from 1997 to 2014 in Hospital Episode Statistics Admitted Patient Care...
January 27, 2018: BMJ Open
https://www.readbyqxmd.com/read/29371334/poor-compliance-and-increased-mortality-depression-and-healthcare-costs-in-patients-with-congenital-adrenal-hyperplasia
#16
Sara Jenkins-Jones, Lotta Parviainen, John Porter, Mike Withe, Martin Whitaker, Sarah E Holden, Christopher Llewellyn Morgan, Craig Currie, Richard J Ross
Objectives To evaluate risks of depression and all-cause mortality, healthcare utilisation costs, and treatment adherence in congenital adrenal hyperplasia (CAH) in the UK. Design and Methods A retrospective, matched-cohort study using UK primary-care data from the Clinical Practice Research Datalink linked to hospital and death-certification data. Patients diagnosed with CAH and having ≥1 corticosteroid prescription were matched 1:10 to reference subjects. Risk of death and lifetime prevalence of depression were compared using Cox regression models...
January 25, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29371284/comparative-effectiveness-of-novel-oral-anticoagulants-in-uk-patients-with-non-valvular-atrial-fibrillation-and-chronic-kidney-disease-a-matched-cohort-study
#17
Simone Y Loo, Janie Coulombe, Sophie Dell'Aniello, James M Brophy, Samy Suissa, Christel Renoux
OBJECTIVES: To evaluate the effectiveness and safety of novel oral anticoagulants (NOACs) compared with vitamin K antagonists (VKAs) among patients with non-valvular atrial fibrillation (NVAF), particularly those with chronic kidney disease (CKD). DESIGN: Population-based matched cohort study. SETTING: Over 670 primary care practices in the UK, contributing to the Clinical Practice Research Datalink. PARTICIPANTS: Up to 6818 adult patients newly treated with NOACs between 2011 and 2016, matched 1:1 to new users of VKAs on age, sex and high-dimensional propensity score...
January 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29369409/parkinson-s-disease-and-the-risk-of-epileptic-seizures
#18
Katharina Gruntz, Marlene Bloechliger, Claudia Becker, Susan S Jick, Peter Fuhr, Christoph R Meier, Stephan Rüegg
Objective To assess the association between incident Parkinson's disease (PD) and subsequent incident epileptic seizures. Methods We conducted a retrospective cohort study with a nested case-control analysis using data from the UK Clinical Practice Research Datalink. We identified patients aged ≥40 years with an incident diagnosis of PD between 1995 and 2016 and a matched comparison group of PD-free individuals. We calculated crude incidence rates (IRs) with 95% confidence intervals (CIs) of epileptic seizures in PD patients and the PD-free comparison group, and corresponding crude incidence rate ratios (IRRs)...
January 25, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29366925/pharmacological-intervention-in-hypertension-using-beta-blockers-real-world-evidence-for-long-term-effectiveness
#19
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
https://www.readbyqxmd.com/read/29363763/oral-bisphosphonate-use-and-age-related-macular-degeneration-retrospective-cohort-and-nested-case-control-study
#20
Cesar Garriga, Michael Pazianas, Samuel Hawley, Antonella Delmestri, Daniel Prieto-Alhambra, Cyrus Cooper, Andrew Judge
Our objective here was to determine whether oral bisphosphonate (BP) use is associated with the incidence of age-related macular degeneration (AMD). We performed a population-based study using electronic health records from UK primary care (Clinical Practice Research Datalink). A cohort of 13,974 hip fracture patients (1999-2013) was used to conduct (1) a propensity score-matched cohort analysis and (2) a nested case-control analysis. Hip fracture patients were aged ≥50 years without AMD diagnosis before hip fracture date or in the first year of follow-up...
January 24, 2018: Annals of the New York Academy of Sciences
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