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https://www.readbyqxmd.com/read/28635339/methods-for-estimating-costs-in-patients-with-hyperlipidemia-experiencing-their-first-cardiovascular-event-in-the-united-kingdom
#1
Mark D Danese, Michelle Gleeson, Robert I Griffiths, David Catterick, Lucie Kutikova
AIMS: Methods for integrating external costs into clinical databases are not well-characterized. The purpose of this research was to describe and implement methods for estimating the cost of hospitalizations, prescriptions, and general practitioner and specialist visits used to manage hyperlipidemia patients experiencing cardiovascular (CV) events in the United Kingdom (UK). METHODS: This study was a retrospective cohort study using the Clinical Practice Research Datalink and Hospital Episode Statistics data...
June 21, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28633374/cohort-study-of-preoperative-blood-pressure-and-risk-of-30-day-mortality-after-elective-non-cardiac-surgery
#2
S Venkatesan, P R Myles, H J Manning, A M Mozid, C Andersson, M E Jørgensen, J G Hardman, S R Moonesinghe, P Foex, M Mythen, M P W Grocott, R D Sanders
Background: Preoperative blood pressure (BP) thresholds associated with increased postoperative mortality remain unclear. We investigated the relationship between preoperative BP and 30-day mortality after elective non-cardiac surgery. Methods: We performed a cohort study of primary care data from the UK Clinical Practice Research Datalink (2004-13). Parsimonious and fully adjusted multivariable logistic regression models, including restricted cubic splines for numerical systolic and diastolic BP, for 30-day mortality were constructed...
June 15, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28614231/incidence-prevalence-and-natural-history-of-primary-sclerosing-cholangitis-in-the-united-kingdom
#3
Huifang Liang, Sudhakar Manne, Jesse Shick, Trevor Lissoos, Paul Dolin
Primary sclerosing cholangitis (PSC) is a rare obliterative fibrotic condition of the bile ducts. We assessed PSC epidemiology and natural history within the UK Clinical Practice Research Datalink (CPRD).Incidence and natural history of PSC were evaluated in a retrospective cohort study using linkage of CPRD, Hospital Episode Statistics, and Office for National Statistics data. Data from age, sex, and general practice-matched population controls provided a context for the incident PSC patients. Liver disease other than PSC was defined as autoimmune hepatitis, hepatitis, hepatomegaly, liver failure, cirrhosis, portal hypertension, cholangiocarcinoma, or hepatobiliary cancer...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28608143/resource-utilization-among-glaucoma-patients-in-the-uk-treated-with-beta-blocker-and-non-beta-blocker-adjunctive-therapy-a-retrospective-cohort-analysis
#4
Ananth Viswanathan, Claudio Spera, Anmol Mullins, David Covert, Judit Banhazi, Paul McDwyer, Eibhlin Hudson, Alberto Ferreira
INTRODUCTION: Few studies have examined outcomes and potential complications among glaucoma patients who are prescribed topical beta-blockers. This study examined resource usage (number of GP visits and hospitalizations) and diagnoses of respiratory or cardiovascular conditions among glaucoma patients prescribed beta-blockers compared to patients not prescribed beta-blockers. METHODS: A retrospective cohort analysis was conducted using data from the UK Clinical Practice Research Datalink (CPRD) database over the period January 1, 2006 to March 31, 2014...
May 30, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28598998/financial-incentives-improve-recognition-but-not-treatment-of-cardiovascular-risk-factors-in-severe-mental-illness
#5
Carol L Wilson, Kirsty M Rhodes, Rupert A Payne
OBJECTIVES: Severe mental illness (SMI) is associated with premature cardiovascular disease, prompting the UK primary care payment-for-performance system (Quality and Outcomes Framework, QOF) to incentivise annual physical health reviews. This study aimed to assess the QOF's impact on detection and treatment of cardiovascular risk factors in people with SMI. METHODS: A retrospective open cohort study of UK general practice was conducted between 1996 and 2014, using segmented logistic regression with 2004 and 2011 as break points, reflecting the introduction of relevant QOF incentives in these years...
2017: PloS One
https://www.readbyqxmd.com/read/28589222/prescribing-of-medication-for-attention-deficit-hyperactivity-disorder-among-young-people-in-the-clinical-practice-research-datalink-2005-2013-analysis-of-time-to-cessation
#6
Tamsin Newlove-Delgado, Tamsin J Ford, William Hamilton, Ken Stein, Obioha C Ukoumunne
The aim of this study was to examine the time to cessation of ADHD medication amongst young people with ADHD aged 16 in the period 2005-2013. Previous studies of prescribing in primary care reported high rates of medication cessation amongst 16 and 17 year olds with ADHD. The examination of trends since the introduction of new NICE guidance in 2008 will support service planning and improvement of outcomes over the vulnerable transition period from child to adult services. We used primary care records from the Clinical Practice Research Datalink and identified cases prescribed ADHD medication at the time of their 16th birthday during the study period...
June 6, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28587655/gout-and-subsequent-erectile-dysfunction-a-population-based-cohort-study-from-england
#7
Alyshah Abdul Sultan, Christian Mallen, Richard Hayward, Sara Muller, Rebecca Whittle, Matthew Hotston, Edward Roddy
BACKGROUND: An association has been suggested between gout and erectile dysfunction (ED), however studies quantifying the risk of ED amongst gout patients are lacking. We aimed to precisely determine the population-level absolute and relative rate of ED reporting among men with gout over a decade in England. METHODS: We utilised the UK-based Clinical Practice Research Datalink to identify 9653 men with incident gout age- and practice-matched to 38,218 controls. Absolute and relative rates of incident ED were calculated using Cox regression models...
June 6, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28583425/dapagliflozin-therapy-for-type-2-diabetes-in-primary-care-changes-in-hba1c-weight-and-blood-pressure-over-2-years-follow-up
#8
J Wilding, C Bailey, U Rigney, B Blak, M Kok, C Emmas
AIMS: To investigate prescribing patterns and effect of dapagliflozin among individuals with T2DM using UK primary care data. METHODS: Adult patients with T2DM initiating dapagliflozin treatment were identified from the Clinical Practice Research Datalink. Changes in HbA1c, body weight and systolic blood pressure were assessed in subgroups defined by glucose lowering treatment at baseline and compliance with the Summary of Product Characteristics. Logistic regression examined the association of baseline characteristics with achievement of target HbA1c (≤53mmol/mol) and weight reduction (by ≥3...
June 2, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28573394/cancer-risk-among-insulin-users-comparing-analogues-with-human-insulin-in-the-caring-five-country-cohort-study
#9
Anna But, Marie L De Bruin, Marloes T Bazelier, Vidar Hjellvik, Morten Andersen, Anssi Auvinen, Jakob Starup-Linde, Marjanka K Schmidt, Kari Furu, Frank de Vries, Øystein Karlstad, Nils Ekström, Jari Haukka
AIMS/HYPOTHESIS: The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. METHODS: National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112)...
June 1, 2017: Diabetologia
https://www.readbyqxmd.com/read/28571893/selective-serotonin-reuptake-inhibitors-and-cataract-risk-a-case-control-analysis
#10
Claudia Becker, Susan S Jick, Christoph R Meier
PURPOSE: Use of selective serotonin reuptake inhibitors (SSRIs) has been associated with an increased cataract risk. We aimed to assess cataract risk after exposure to SSRI or to other antidepressant drugs in a large electronic primary care database. DESIGN: Case-control study. PARTICIPANTS: The study population was derived from the UK-based Clinical Practice Research Datalink (CPRD). We included patients with first-time cataract aged ≥40 years between 1995 and 2015 and an equal number of cataract-free controls matched on age, sex, general practice, date of cataract recording (i...
May 29, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28569614/stability-of-blood-eosinophil-count-in-patients-with-copd-in-the-uk-clinical-practice-research-datalink
#11
Sarah H Landis, Robert Suruki, Emma Hilton, Chris Compton, Nicholas W Galwey
Blood eosinophil counts may be predictive of corticosteroid response in chronic obstructive pulmonary disease (COPD) patients. However, little is known about measurement stability, which is important for understanding the utility of blood eosinophil counts as a potential biomarker. We evaluated the stability of blood eosinophil counts over 1 year in a population-based cohort of patients with COPD in primary care. Patients were aged ≥ 40 years with forced expiratory volume in 1 second/forced vital capacity < 0...
June 1, 2017: COPD
https://www.readbyqxmd.com/read/28569278/governance-and-oversight-of-researcher-access-to-electronic-health-data-the-role-of-the-independent-scientific-advisory-committee-for-mhra-database-research-2006-2015
#12
P Waller, J A Cassell, M H Saunders, R Stevens
In order to promote understanding of UK governance and assurance relating to electronic health records research, we present and discuss the role of the Independent Scientific Advisory Committee (ISAC) for MHRA database research in evaluating protocols proposing the use of the Clinical Practice Research Datalink. We describe the development of the Committee's activities between 2006 and 2015, alongside growth in data linkage and wider national electronic health records programmes, including the application and assessment processes, and our approach to undertaking this work...
March 2017: Journal of the Royal College of Physicians of Edinburgh
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
#13
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
#14
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
#15
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...
June 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
#16
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
#17
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
#18
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
#19
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)...
June 6, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28490903/cardiovascular-risks-in-smokers-treated-with-nicotine-replacement-therapy-a-historical-cohort-study
#20
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
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