scholarly journals 1481. Incidence of Pertussis in Older Adults in England and the United Kingdom: A Large, Retrospective Database Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S742-S742
Author(s):  
Emmanuel Aris ◽  
Esse Ifebi Akpo ◽  
Amit Bhavsar ◽  
Lauriane Harrington ◽  
Evie Merinopoulou ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
United Kingdom ◽  
Secondary Care ◽  
Clinical Practice Research Datalink ◽  
Database Analysis ◽  
The United Kingdom ◽  
Retrospective Database Analysis ◽  
The Uk ◽  
Retrospective Database

Abstract Background Pertussis affects people of all ages and can lead to severe complications in adults, including hospitalization. Pertussis immunity, whether vaccine-induced or from natural infection, wanes over time. Therefore, despite extensive pediatric vaccination against pertussis, adults remain susceptible to the disease. Here we present the reported incidence of pertussis in people ≥ 50 years old (≥ 50yo) in England and the United Kingdom (UK). Methods We performed an observational, retrospective database analysis using the UK Clinical Practice Research Datalink GOLD and Aurum primary care databases, and Hospital Episode Statistics database when available for English subjects (HES-Eng), 2009-2018. Occurrence of pertussis was identified by diagnostic codes recorded in primary care only for the UK subset, and primary care and/or secondary care for HES-Eng. Results In the ≥ 50yo UK population, a total of 47.1 million (m) person-years of follow-up (PYFU) including 28.5m PYFU for HES-Eng, were included. In the UK, the pertussis Incidence Rate (IR) across all years was 5.44 per 100,000 PYFU. Yearly IRs ranged from 0.79 – 11.40 per 100,000 PYFU and reflected the cyclic epidemiology of pertussis. A peak of IR was observed in 2012, known to be an outbreak year, and observed IRs were higher in 2013-2018 (4.75 – 9.73 per 100,000 PYFU) than 2009-2011 (0.79 – 1.48 per 100,000 PYFU). In the HES-Eng population, overall IR was 5.76 per 100,000 PYFU. IRs were highest in the younger age groups (HES-Eng: 8.88 in 50-54 yo; 1.42 in ≥ 85 yo) (see table 1 and 2). Table 1 Table 2 Conclusion The observed reported IR of pertussis was similar in the UK and HES-Eng populations, noting the inclusion of secondary care diagnoses in the latter. The dynamics of IRs across years are consistent with estimated IRs from Public Health England data. Considering the burden of pertussis established elsewhere in older adults, and their non-negligible contribution to the whole population incidence, strategies for the prevention of pertussis should include this age group. Disclosures Emmanuel Aris, PhD, the GSK group of companies (Employee, Shareholder) Esse Ifebi Akpo, n/a, the GSK group of companies (Employee, Shareholder) Amit Bhavsar, MBBS, MHA, the GSK group of companies (Employee) Lauriane Harrington, n/a, the GSK group of companies (Employee) Evie Merinopoulou, MSc, Evidera Ltd (Employee)the GSK group of companies (Consultant) Nicola Sawalhi-Leckenby, MSc, Evidera Ltd (Employee)the GSK group of companies (Consultant) Elisa Turriani, PhD, the GSK group of companies (Employee) Kinga Meszaros, MBA, the GSK group of companies (Employee, Shareholder) Dimitra Lambrelli, PhD, MPharm, Evidera Ltd (Employee)the GSK group of companies (Consultant) Piyali Mukherjee, MBBS, MPH, the GSK group of companies (Employee, Shareholder)

scholarly journals Pneumococcal vaccine coverage among individuals aged 18 to 64 years old with underlying medical conditions in the UK: a retrospective database analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ian Matthews ◽  
Xiaoyan Lu ◽  
Qian Xia ◽  
Wynona Black ◽  
Bayad Nozad
Keyword(s):  
Pneumococcal Vaccination ◽  
Clinical Practice Research Datalink ◽  
Medical Conditions ◽  
Database Analysis ◽  
Factors Associated ◽  
Increased Risk ◽  
Retrospective Database Analysis ◽  
The Uk ◽  
Retrospective Database

Abstract Background In the UK certain groups with pre-disposing conditions are eligible for vaccination with the pneumococcal polysaccharide vaccine (PPV23). Uptake of the vaccine in these individuals has not been reported for 10 years. Hence this study investigated the rates of pneumococcal vaccination, the time to vaccination since diagnosis, and factors associated with vaccination in individuals aged 18–64 years with certain underlying medical conditions. Methods A retrospective database analysis was conducted using the Clinical Practice Research Datalink (CPRD). Individuals aged 18 to 64 years who had a diagnosis for underlying medical conditions of interest at the index date (January 1, 2011 to December 31, 2015) were included in this study. Both underlying conditions and pneumococcal vaccination were identified using Read codes. A multivariable logistic regression model was used to identify factors associated with pneumococcal vaccination. Results A total of 99,153 individuals with underlying medical conditions were included in this study. Within 1 year of follow-up, 13.6% had received pneumococcal vaccination. This figure rose to 32.0% after 4 years of follow-up. The mean time between diagnosis and vaccination was 148.7 days across the overall cohort. Based on multivariate analysis of results, individuals with chronic heart disease, chronic kidney disease, chronic liver disease, chronic respiratory disease or diabetes mellitus were significantly less likely (P < 0.0001) to be vaccinated than those with immunosuppression. Individuals were significantly more likely to receive a pneumococcal vaccination if they received an influenza vaccination in the first year of follow-up than those who did not (P < 0.001). Conclusions Despite the Joint Committee on Vaccination and Immunisation (JCVI) recommendations for pneumococcal vaccination in clinical risk groups, rates of pneumococcal vaccination are suboptimal in the UK for individuals aged 18–64 with underlying medical conditions. Further emphasis should be made on the importance of increased pneumococcal vaccination coverage in the UK, given the increased risk of morbidity and mortality associated with indicative underlying medical conditions.

scholarly journals Effectiveness of seasonal influenza vaccine for adults and children in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2015/16 end-of-season results

2016 ◽  
Vol 21 (38) ◽  
Author(s):  
Richard Pebody ◽  
Fiona Warburton ◽  
Joanna Ellis ◽  
Nick Andrews ◽  
Alison Potts ◽  
...  
Keyword(s):  
Primary Care ◽  
United Kingdom ◽  
Influenza Vaccine ◽  
Influenza A ◽  
Immunisation Programme ◽  
Influenza B ◽  
Live Attenuated Influenza Vaccine ◽  
The United Kingdom ◽  
Influenza A H1n1 ◽  
The Uk

The United Kingdom (UK) is in the third season of introducing universal paediatric influenza vaccination with a quadrivalent live attenuated influenza vaccine (LAIV). The 2015/16 season in the UK was initially dominated by influenza A(H1N1)pdm09 and then influenza of B/Victoria lineage, not contained in that season’s adult trivalent inactivated influenza vaccine (IIV). Overall adjusted end-of-season vaccine effectiveness (VE) was 52.4% (95% confidence interval (CI): 41.0–61.6) against influenza-confirmed primary care consultation, 54.5% (95% CI: 41.6–64.5) against influenza A(H1N1)pdm09 and 54.2% (95% CI: 33.1–68.6) against influenza B. In 2–17 year-olds, adjusted VE for LAIV was 57.6% (95% CI: 25.1 to 76.0) against any influenza, 81.4% (95% CI: 39.6–94.3) against influenza B and 41.5% (95% CI: −8.5 to 68.5) against influenza A(H1N1)pdm09. These estimates demonstrate moderate to good levels of protection, particularly against influenza B in children, but relatively less against influenza A(H1N1)pdm09. Despite lineage mismatch in the trivalent IIV, adults younger than 65 years were still protected against influenza B. These results provide reassurance for the UK to continue its influenza immunisation programme planned for 2016/17.

scholarly journals Non-medical prescribing in primary care in the United Kingdom: an overview of the current literature

2021 ◽  
Vol 3 (9) ◽  
pp. 352-361
Author(s):  
Amanda Armstrong ◽  
Andrea Manfrin ◽  
Josephine Gibson
Keyword(s):  
Primary Care ◽  
United Kingdom ◽  
English Language ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
The United Kingdom ◽  
Organisational Support ◽  
Primary Care Patients ◽  
Negative Perceptions ◽  
The Uk

Background: Non-medical prescribers (NMPs) are perceived as a complement to busy general practice in primary care. Aim: To conduct an overview of the literature available on the role and impact of non-medical prescribing (NMP) on primary care patients. Method: The search was conducted using multiple databases to find articles published between January 2015-January 2021. Inclusion criteria: NMPs in primary care in the United Kingdom, written in English language. Exclusion criteria: research conducted in secondary care or outside the UK. Findings: 285 studies were identified; 15 were eligible for critical appraisal. Key themes were: NMP's positive perceptions were autonomy, job satisfaction and colleague support; negative perceptions included risk, lack of continuous professional development (CPD), organisational support. Conclusion: By reviewing the perceptions of NMPs in primary care, organisations can ensure when employing new NMPs that the adequate CPD and support is in place. Thereby reducing NMPs concerns about the ligation risk of prescribing.

scholarly journals International Comparison in Opiate Prescribing for New Users in Primary Care using Electronic Medical Record Data

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Robyn Tamblyn ◽  
Nadyne Girard ◽  
Bettina Habib ◽  
William Dixon ◽  
Meghna Jani ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
United Kingdom ◽  
North America ◽  
Cancer Pain ◽  
Cancer Patients ◽  
The United Kingdom ◽  
Record Data ◽  
The Uk ◽  
The U.S

IntroductionThe opioid epidemic in North America has, in part, been attributed to an increase in opiate use for non-cancer pain and the prescription of more potent molecules. In contrast, the United Kingdom appears unaffected by this crisis, possibly because of differences in primary care prescribing, or health system policies. ObjectiveTo determine if there are differences in opiate prescribing for new users in primary care in the United Kingdom, United States, and Canada. ApproachElectronic health record data from Quebec, Canada (MOXXI), the United States (Partners Health Care, Boston MA), and the United Kingdom (CPRD random sample of 600,000) were used to identify new users of opiates (no prior prescription in 2 years), at least 18 years old between 2006-2016. Cancer patients were excluded after harmonizing equivalent READ and ICD9/10 codes. Generic drug names in each jurisdiction were mapped to the WHO ATC classification, and characterized using morphine milligram equivalents (MME). ResultsOverall 655,877 new users were identified, of whom 78% of 58,286 (U.S.), 88% of 6,251 (Canada), and 96% of 600,000 (UK) were non-cancer patients. Mean age of new users was 49 (SD 16) in the US, 57 (SD 16) in Canada, and 52 (SD 19) in the UK. 57.6% (UK) to 67.3% (US) of new users were women. In the UK, 86.5% of patients were started on codeine (MME:0.15), compared to 43.9% in Canada and 8.5% in the U.S. In the U.S 65.0\% were started on oxycodone (MME:1.5), and 10.9% on hydrocodone (MME:1). In Canada, tramadol (18.2%; MME: 0.1) followed by oxycodone (13.2%) were the next most commonly prescribed drugs. Conclusion/ImplicationsSubstantial differences in opioid prescribing practices for non-cancer pain were observed between the UK and Canadian and United States sites. The predilection to start patients on more potent opiates in North America may be a contributing cause to the opiate epidemic.

scholarly journals First maintenance therapy for COPD in the UK between 2009 and 2012: a retrospective database analysis

2016 ◽  
Vol 26 (1) ◽  
Author(s):  
David Price ◽  
Marc Miravitlles ◽  
Ian Pavord ◽  
Mike Thomas ◽  
Jadwiga Wedzicha ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Database Analysis ◽  
Retrospective Database Analysis ◽  
The Uk ◽  
Retrospective Database
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