FRI0567 Trends in Annual Consultation Incidence of Clinical Osteoarthritis between 1992-2013 in UK Primary Care: Analysis of The Clinical Practice Research Datalink

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 646.2-646
Author(s):  
D. Yu ◽  
G. Peat ◽  
J. Bedson ◽  
K. Jordan
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Annual Consultation

scholarly journals Evidence of disparities in the provision of the maternal postpartum 6-week check in primary care in England, 2015–2018: an observational study using the Clinical Practice Research Datalink (CPRD)

2021 ◽  
pp. jech-2021-216640
Author(s):  
Yangmei Li ◽  
Jennifer J Kurinczuk ◽  
Christopher Gale ◽  
Dimitrios Siassakos ◽  
Claire Carson
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Policy Change ◽  
Post Partum ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Younger Women ◽  
Preterm Babies ◽  
Deprived Areas

BackgroundA maternal postpartum 6-week check (SWC) with a general practitioner (GP) is now considered an essential service in England, a recent policy change intended to improve women’s health. We aimed to provide an up-to-date snapshot of the prevalence of SWC prior to the policy change as a baseline, and to explore factors associated with having a late or no check.MethodsWe conducted a cohort study using primary care records in England (Clinical Practice Research Datalink (CPRD)). 34 337 women who gave birth between 1 July 2015 and 30 June 2018 and had ≥12 weeks of follow-up post partum were identified in the CPRD Pregnancy Register. The proportion who had evidence of an SWC with a GP was calculated, and regression analysis was used to assess the association between women’s characteristics and risks of a late or no check.ResultsSixty-two per cent (95% CI 58% to 67%) of women had an SWC recorded at their GP practice within 12 weeks post partum, another 27% had other consultations. Forty per cent had an SWC at the recommended 6–8 weeks, 2% earlier and 20% later. A late or no check was more common among younger women, mothers of preterm babies or those registered in more deprived areas.ConclusionsNearly 40% of women did not have a postpartum SWC recorded. Provision or uptake was not equitable; younger women and those in more deprived areas were less likely to have a record of such check, suggesting postpartum care in general practice may be missing some women who need it most.

scholarly journals Use of multiple inflammatory marker tests in primary care: using Clinical Practice Research Datalink to evaluate accuracy

2019 ◽  
Vol 69 (684) ◽  
pp. e462-e469 ◽  
Author(s):  
Jessica Watson ◽  
Hayley E Jones ◽  
Jonathan Banks ◽  
Penny Whiting ◽  
Chris Salisbury ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Test Performance ◽  
Predictive Value ◽  
Inflammatory Markers ◽  
Inflammatory Marker ◽  
Superior Performance ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Autoimmune Conditions

BackgroundResearch comparing C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and plasma viscosity (PV) in primary care is lacking. Clinicians often test multiple inflammatory markers, leading to concerns about overuse.AimTo compare the diagnostic accuracies of CRP, ESR, and PV, and to evaluate whether measuring two inflammatory markers increases accuracy.Design and settingProspective cohort study in UK primary care using the Clinical Practice Research Datalink.MethodThe authors compared diagnostic test performance of inflammatory markers, singly and paired, for relevant disease, defined as any infections, autoimmune conditions, or cancers. For each of the three tests (CRP, ESR, and PV), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under receiver operator curve (AUC) were calculated.ResultsParticipants comprised 136 961 patients with inflammatory marker testing in 2014; 83 761 (61.2%) had a single inflammatory marker at the index date, and 53 200 (38.8%) had multiple inflammatory markers. For ‘any relevant disease’, small differences were seen between the three tests; AUC ranged from 0.659 to 0.682. CRP had the highest overall AUC, largely because of marginally superior performance in infection (AUC CRP 0.617, versus ESR 0.589, P<0.001). Adding a second test gave limited improvement in the AUC for relevant disease (CRP 0.682, versus CRP plus ESR 0.688, P<0.001); this is of debatable clinical significance. The NPV for any single inflammatory marker was 94% compared with 94.1% for multiple negative tests.ConclusionTesting multiple inflammatory markers simultaneously does not increase ability to rule out disease and should generally be avoided. CRP has marginally superior diagnostic accuracy for infections, and is equivalent for autoimmune conditions and cancers, so should generally be the first-line test.

scholarly journals Drug therapy for alcohol dependence in primary care in the UK: A Clinical Practice Research Datalink study

PLoS ONE ◽  
2017 ◽  
Vol 12 (3) ◽  
pp. e0173272 ◽  
Author(s):  
Andrew Thompson ◽  
Darren M. Ashcroft ◽  
Lynn Owens ◽  
Tjeerd P. van Staa ◽  
Munir Pirmohamed
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Drug Therapy ◽  
Alcohol Dependence ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
The Uk

scholarly journals Retrospective, multicohort analysis of the Clinical Practice Research Datalink (CPRD) to determine differences in the cost of medication wastage, dispensing fees and prescriber time of issuing either short (<60 days) or long (≥60 days) prescription lengths in primary care for common, chronic conditions in the UK

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019382 ◽  
Author(s):  
Brett Doble ◽  
Rupert Payne ◽  
Amelia Harshfield ◽  
Edward C F Wilson
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Secondary Outcome ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Lipid Management ◽  
Medication Wastage ◽  
The Uk ◽  
The Cost ◽  
Repeat Prescriptions

ObjectivesTo investigate patterns of early repeat prescriptions and treatment switching over an 11-year period to estimate differences in the cost of medication wastage, dispensing fees and prescriber time for short (<60 days) and long (≥60 days) prescription lengths from the perspective of the National Health Service in the UK.SettingRetrospective, multiple cohort study of primary care prescriptions from the Clinical Practice Research Datalink.ParticipantsFive random samples of 50 000 patients each prescribed oral drugs for (1) glucose control in type 2 diabetes mellitus (T2DM); (2) hypertension in T2DM; (3) statins (lipid management) in T2DM; (4) secondary prevention of myocardial infarction; and (5) depression.Primary and secondary outcome measuresThe volume of medication wastage from early repeat prescriptions and three other types of treatment switches was quantified and costed. Dispensing fees and prescriber time were also determined. Total unnecessary costs (TUC; cost of medication wastage, dispensing fees and prescriber time) associated with <60 day and ≥60 day prescriptions, standardised to a 120-day period, were then compared.ResultsLonger prescription lengths were associated with more medication waste per prescription. However, when including dispensing fees and prescriber time, longer prescription lengths resulted in lower TUC. This finding was consistent across all five cohorts. Savings ranged from £8.38 to £12.06 per prescription per 120 days if a single long prescription was issued instead of multiple short prescriptions. Prescriber time costs accounted for the largest component of TUC.ConclusionsShorter prescription lengths could potentially reduce medication wastage, but they may also increase dispensing fees and/or the time burden of issuing prescriptions.

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