Changing Epidemiology of Bariatric Surgery in the UK: Cohort Study Using Primary Care Electronic Health Records

ObjectiveThis study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2–15-year-old children in England and compare trends over the last two decades.DesignCohort study of primary care electronic health records.Setting375 general practices in England that contribute to the UK Clinical Practice Research Datalink.PatientsIndividual participants were sampled if they were aged between 2 and 15 years during the period 1994–2013 and had one or more records of body mass index (BMI).Main outcome measurePrevalence of overweight (including obesity) was defined as a BMI equal to or greater than the 85th centile of the 1990 UK reference population.ResultsData were analysed for 370 544 children with 507 483 BMI records. From 1994 to 2003, the odds of overweight and obesity increased by 8.1% per year (95% CI 7.2% to 8.9%) compared with 0.4% (−0.2% to 1.1%) from 2004 to 2013. Trends were similar for boys and girls, but differed by age groups, with prevalence stabilising in 2004 to 2013 in the younger (2–10 year) but not older (11–15 year) age group, where rates continued to increase.ConclusionsPrimary care electronic health records in England may provide a valuable resource for monitoring obesity trends. More than a third of UK children are overweight or obese, but the prevalence of overweight and obesity may have stabilised between 2004 and 2013.

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Provider Responses to Patients Controlling Access to their Electronic Health Records: A Prospective Cohort Study in Primary Care

Journal of General Internal Medicine ◽

10.1007/s11606-014-3053-0 ◽

2014 ◽

Vol 30 (S1) ◽

pp. 31-37 ◽

Cited By ~ 23

Author(s):

William M. Tierney ◽

Sheri A. Alpert ◽

Amy Byrket ◽

Kelly Caine ◽

Jeremy C. Leventhal ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Electronic Health Records ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Health Records ◽

Electronic Health

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Adipositas-Chirurgie – Ist bariatrische Chirurgie kosteneffektiv?

Gesundheitsökonomie & Qualitätsmanagement ◽

10.1055/s-0043-117333 ◽

2017 ◽

Vol 22 (04) ◽

pp. 182-183

Author(s):

Cornelia Blaich

Keyword(s):

Bariatric Surgery ◽

Cohort Study ◽

Cost Effectiveness ◽

Electronic Health Records ◽

Bariatrische Chirurgie ◽

Cost Effectiveness Analysis ◽

Health Records ◽

Typ 2 Diabetes ◽

Effectiveness Analysis ◽

Electronic Health

Gulliford MC et al. Costs and Outcomes of Increasing Access to Bariatric Surgery: Cohort Study and Cost-Effectiveness Analysis Using Electronic Health Records. Value Health 2017; 20: 85–92 Ziele der bariatrischen Chirurgie bei Patienten mit morbider Adipositas sind neben der Gewichtsreduktion die Remission oder geringere Inzidenz eines Typ-2-Diabetes und eine Reduktion der Sterblichkeit. Die Autoren untersuchen in einer Kohortenstudie die Auswirkungen und Kosteneffektivität der bariatrischen Chirurgie im Vergleich zu einer nicht chirurgischen Behandlung der Adipositas.

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MORTALITY OF CARE HOME RESIDENTS AND COMMUNITY-DWELLING CONTROLS DURING THE COVID-19 PANDEMIC IN 2020: MATCHED COHORT STUDY

10.1101/2021.04.24.21255968 ◽

2021 ◽

Author(s):

Martin C Gulliford ◽

Emma C Rezel-Potts

Keyword(s):

Primary Care ◽

Cohort Study ◽

Electronic Health Records ◽

Care Home ◽

Community Dwelling ◽

Matched Cohort ◽

Long Term Conditions ◽

Health Records ◽

Matched Cohort Study ◽

Electronic Health

Objective: To estimate mortality of care home residents during the Covid-19 pandemic from primary care electronic health records. Design: Matched cohort study Setting: 1,421 general practices contributing to the Clinical Practice Research Datalink Aurum Database in England. Participants: 217,987 patients aged 18 to 104 years with recorded care home residence in England in the period 2015 to 2020. There were 86,371 care home residents contributing data in 2020, with 29,662 deaths; 83,419 (97%) were matched on age, gender and general practice with 312,607 community-dwelling adults. Main outcome measures: All-cause mortality. Analysis was by Poisson regression adjusting for age, gender, long-term conditions, region, year and calendar week. Results: The highest first wave age-specific mortality rate was 6.02 (95% confidence interval 5.97 to 6.07) per 100 patients per week in men aged 95-104 years between 13th-19th April 2020. Compared with community-dwelling controls, the adjusted rate ratio for mortality of care home residents was 4.95 (4.62 to 5.32) in February 2020, increasing to 8.34 (7.95 to 8.74) in April 2020, declining to 3.93 (3.68 to 4.20) in December 2020. During the week of 13th to 19th April 2020, mortality of care home residents was 10.74 (9.72 to 11.85) times higher than for matched community-dwelling controls. Conclusions: Individual-patient data from primary care electronic health records may be used to estimate mortality in care home residents. Mortality is substantially higher than for community-dwelling comparators and showed a disproportionate increase in the first wave of the Covid-19 pandemic but not the second wave. This study provides evidence to support earlier, decisive action to protect these vulnerable populations in the event of further outbreaks. Prospective investigations of care home mortality are warranted.

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Validity of UK electronic health records to study migrant health: a population-based cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.768 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

N Pathak ◽

P Patel ◽

R Mathur ◽

R Burns ◽

A Gonzalez-Izquierdo ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Electronic Health Records ◽

Barriers To Care ◽

Population Based ◽

Health Records ◽

Migration Status ◽

English Speaking ◽

International Migrants ◽

The Uk

Abstract Background An estimated 14.3% (9.4 million people) of people living in the UK in 2019 were international migrants. Despite this, little is known about how migrants access and use healthcare services. To use electronic healthcare records (EHRs) to study migration health, a valid migration phenotype is necessary: a transparent reproducible algorithm using clinical terminology codes to determine migration status. We have previously described the validity of a migration phenotype in CALIBER data using the Clinical Practice Research Datalink (CPRD), the largest UK primary care EHR. This study further evaluates the phenotype by examining certainty of migration status. Methods This is a population-based cohort study of individuals in CPRD Gold (1997-2018) with a Read term indicating migration to the UK. We describe completeness of recording of migration over time: percentage of individuals recorded as migrants. We also describe cohort size based on certainty of migration status: “definite” (country of birth or visa status terms), “probable” (non-English first/main language terms), and “possible” (non-UK origin terms). Results Overall, 2.5% (403,768/16,071,111) of CPRD had ≥1 of 434 terms indicating migration to the UK. The percentage of recorded migrants per year increased from 0.2% (4,417/2,210,551) in 1997 to 3.64% (100,626/2,761,397) in 2018, following a similar trend to national migration data. 44.27% (178,749/403,768) were “definite” migrants and 53.68% (216,731/403,768) were “probable” migrants. Only 2.05%(8,288/16,071,111) were “possible” migrants. Conclusions We have created a large cohort of international migrants in the UK and certainty of migration status is high. This cohort can be used to study migration health in UK primary care EHR. The large contribution of language terms make this phenotype particularly suitable for understanding healthcare access and use by non-English speaking migrants who may face additional barriers to care. Key messages We have developed a way to study migration health in UK primary care electronic health records. Our method is particularly useful to study healthcare for non-English speaking migrants who may face additional barriers to care.

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Depression, depressive symptoms and treatments in women who have recently given birth: UK cohort study

BMJ Open ◽

10.1136/bmjopen-2018-022152 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022152 ◽

Cited By ~ 8

Author(s):

Irene Petersen ◽

Tomi Peltola ◽

Samuel Kaski ◽

Kate R Walters ◽

Sarah Hardoon

Keyword(s):

Primary Care ◽

Cohort Study ◽

Depressive Symptoms ◽

Electronic Health Records ◽

Postnatal Depression ◽

Selective Serotonin Reuptake Inhibitors ◽

Antidepressant Treatment ◽

Health Records ◽

Electronic Health ◽

Ssri Treatment

ObjectivesTo investigate how depression is recognised in the year after child birth and treatment given in clinical practice.DesignCohort study based on UK primary care electronic health records.SettingPrimary care.ParticipantsWomen who have given live birth between 2000 and 2013.OutcomesPrevalence of postnatal depression, depression diagnoses, depressive symptoms, antidepressant and non-pharmacological treatment within a year after birth.ResultsOf 206 517 women, 23 623 (11%) had a record of depressive diagnosis or symptoms in the year after delivery and more than one in eight women received antidepressant treatment. Recording and treatment peaked 6–8 weeks after delivery. Initiation of selective serotonin reuptake inhibitors (SSRI) treatment has become earlier in the more recent years. Thus, the initiation rate of SSRI treatment per 100 pregnancies (95% CI) at 8 weeks were 2.6 (2.5 to 2.8) in 2000–2004, increasing to 3.0 (2.9 to 3.1) in 2005–2009 and 3.8 (3.6 to 3.9) in 2010–2013. The overall rate of initiation of SSRI within the year after delivery, however, has not changed noticeably. A third of the women had at least one record suggestive of depression at any time prior to delivery and of these one in four received SSRI treatment in the year after delivery.Younger women were most likely to have records of depression and depressive symptoms. (Relative risk for postnatal depression: age 15–19: 1.92 (1.76 to 2.10), age 20–24: 1.49 (1.39 to 1.59) versus age 30–34). The risk of depression, postnatal depression and depressive symptoms increased with increasing social deprivation.ConclusionsMore than 1 in 10 women had electronic health records indicating depression diagnoses or depressive symptoms within a year after delivery and more than one in eight women received antidepressant treatment in this period. Women aged below 30 and from the most deprived areas were at highest risk of depression and most likely to receive antidepressant treatment.

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