scholarly journals Disease burden of diabetes, diabetic retinopathy and their future projections in the UK: cross-sectional analyses of a primary care database

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e050058
Author(s):  
Sajjad Haider ◽  
Rasiah Thayakaran ◽  
Anuradha Subramanian ◽  
Konstantinos A Toulis ◽  
David Moore ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Disease Burden ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Future Projections ◽  
Primary Care Database ◽  
The Uk ◽  
Care Database

ObjectivesTo estimate the current disease burden, trends and future projections for diabetes mellitus (DM) and diabetic retinopathy (DR) in the IQVIA Medical Research Data (IMRD).Participants/design/settingWe performed a cross-sectional study of patients aged 12 and above to determine the prevalence of DM and DR from the IMRD database (primary care database) in January 2017, involving a total population of 1 80 824 patients with DM. We also carried out a series of cross-sectional studies to investigate prevalence trends, and then applied a double exponential smoothing model to forecast the future burden of DM and DR in the UK.ResultsThe crude DM prevalence in 2017 was 5.2%. The DR, sight-threatening retinopathy (STR) and diabetic maculopathy prevalence figures in 2017 were 33.78%, 12.28% and 7.86%, respectively, in our IMRD cross-sectional study. There were upward trends in the prevalence of DM, DR and STR, most marked and accelerating in STR in type 1 DM but slowing in type 2 DM, and in the overall prevalence of DR.ConclusionOur results suggest differential rising trends in the prevalence of DM and DR. Preventive strategies, as well as treatment services planning, can be based on these projected prevalence estimates. Improvements that are necessary for the optimisation of care pathways, and preparations to meet demand and capacity challenges, can also be based on this information. The limitations of the study can be overcome by a future collaborative study linking DR screening and hospital eye services data.

scholarly journals Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1697
Author(s):  
Ashokkumar Thirunavukkarasu ◽  
Abdulmohsen Khaled Almulhim ◽  
Faisal Ahmed Albalawi ◽  
Ziyad Muharib Alruwaili ◽  
Ola Ali Almajed ◽  
...  
Keyword(s):  
Primary Care ◽  
Saudi Arabia ◽  
Diabetic Retinopathy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.

scholarly journals Changes in prescribing rates of sodium-containing medications in the UK from 2009 to 2018: a cross-sectional study with interrupted time series analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043566
Author(s):  
Chengsheng Ju ◽  
Li Wei ◽  
Isla S Mackenzie ◽  
Thomas M MacDonald ◽  
Jacob George
Keyword(s):  
Primary Care ◽  
Interrupted Time Series ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Interrupted Time Series Analysis ◽  
Cross Sectional ◽  
Prescribing Trends ◽  
Slope Change ◽  
Prescription Rates ◽  
The Uk

ObjectiveEffervescent, soluble, dispersible formulations contain considerable amounts of sodium. In 2013, we previously confirmed the association between sodium-containing medications and cardiovascular risks. This study aimed to determine the changes in the prescribing pattern in clinical practice following this publication.DesignA longitudinal cross-sectional study.SettingPrimary care in the UK from 2009 to 2018.ParticipantsPrescribing information in The Health Improvement Network (THIN) and Prescription Cost Analysis (PCA) databases in the UK.Outcome measurementsPrescription rates per 10 000 inhabitants were calculated using the number of prescriptions or the number of drug-using patients over the total number of inhabitants, and the prescription rates were measured at annual intervals. Prescribing trends from 2009 to 2018 were indexed with yearly data from THIN and PCA. Interrupted time series analysis (ITSA) was conducted with monthly data in THIN.ResultsFrom the THIN database, a total of 3 651 419 prescription records from 446 233 patients were included. The prescribing rate of sodium-containing medications changed from 848.3/10 000 inhabitants in 2009 to 571.6/10 000 inhabitants in 2018. The corresponding figures from PCA data were of 631.0/10 000 inhabitants in 2009 and 423.8/10 000 inhabitants in 2018. ITSA showed the prescribing trend reduced significantly during the postpublication period (prescribing rate: slope change=−0.26; 95% CI −0.45 to –0.07; p=0.009; proportion of patients: slope change=−0.22; 95% CI −0.35 to –0.09; p<0.001), but no change in postpublication level from baseline. The prescribing rates for the non-sodium-containing standard formulations were relatively stable over the study period. The reduction in the proportion of patients using sodium-containing medications was only significant in patients over 45 years old.ConclusionsThe prescribing of sodium-containing medications in the UK primary care has declined significantly during the postpublication period. Changes in the prescribing trends for sodium-containing medications varied across regions of the UK and patient age groups.

scholarly journals Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031537
Author(s):  
Kathryn Mansfield ◽  
Elizabeth Crellin ◽  
Rachel Denholm ◽  
Jennifer K Quint ◽  
Liam Smeeth ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Gold Standard ◽  
Alcohol Use Disorders ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Consumption Data ◽  
The Uk

BackgroundSince 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.ObjectiveTo investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.Design and settingCross-sectional study in the Clinical Practice Research Datalink.ParticipantsWe included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.Primary and secondary outcome measuresWe calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (Alcohol Use Disorders Identification Test (AUDIT)) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.ResultsIn 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous 5 years. Recording of alcohol consumption was more common among women, older people, ex-smokers and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last 5 years, but <10% had an AUDIT or Fast Alcohol Screening Test (FAST) alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.ConclusionsHalf of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.

scholarly journals Diagnosis, assessment, and treatment of childhood eczema in primary care: cross-sectional study

BJGP Open ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. bjgpopen17X100821 ◽  
Author(s):  
Laureen Jacquet ◽  
Daisy M Gaunt ◽  
Kirsty Garfield ◽  
Matthew J Ridd
Keyword(s):  
Primary Care ◽  
Diagnostic Criteria ◽  
Feasibility Study ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Severity Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Assessment And Treatment ◽  
The Uk

BackgroundThe majority of children with eczema in the UK are looked after in primary care yet we know little about their care in this setting.AimTo compare the diagnosis, assessment, and treatment of eczema in primary care with published diagnostic criteria and management guidelines.Design & settingCross-sectional study using data from a randomised controlled feasibility study. General practices, UK.MethodBaseline data from children aged 1 month to 5 years recruited ‘in-consultation’ for the Choice of Moisturiser in Eczema Treatment (COMET) feasibility study was used. These included clinician diagnosis and global severity assessment; the parent-completed Patient Orientated Eczema Measure (POEM); a questionnaire about eczema treatments, including use of topical corticosteroid (TCS); and, the Eczema Area Severity Index (EASI) carried out by trained researchers. Descriptive analyses were undertaken to compare diagnoses with UK diagnostic criteria, severity assessments, and treatment with the National Institute for Health and Care Excellent (NICE) guidance.ResultsData were available for 90 participants. Only 46% of participants labelled as having eczema met the UK diagnostic criteria. Agreement between the global severity assessment by a healthcare practitioner with the EASI and POEM measures of eczema severity were 44% and 48% respectively. Emollients and TCSs were underused with 44% of participants not using any emollient and 46% using one or more TCSs. The ‘match’ between eczema severity and TCSs potency was poor.ConclusionDiscrepancies were found between the diagnosis, assessment, and treatment of children with eczema in primary care, and UK diagnostic criteria and guidelines. Further investigation to explore the reasons for this discordance, and whether it matters, is needed.

scholarly journals Relationship between prescribing of antibiotics and other medicines in primary care: a cross-sectional study

2018 ◽  
Vol 69 (678) ◽  
pp. e42-e51 ◽  
Author(s):  
Yan Li ◽  
Anna Mölter ◽  
Andrew White ◽  
William Welfare ◽  
Victoria Palin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Study ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Antibiotic Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
General Practices ◽  
The Uk

BackgroundHigh levels of antibiotic prescribing are a major concern as they drive antimicrobial resistance. It is currently unknown whether practices that prescribe higher levels of antibiotics also prescribe more medicines in general.AimTo evaluate the relationship between antibiotic and general prescribing levels in primary care.Design and settingCross-sectional study in 2014–2015 of 6517 general practices in England using NHS digital practice prescribing data (NHS-DPPD) for the main study, and of 587 general practices in the UK using the Clinical Practice Research Datalink for a replication study.MethodLinear regression to assess determinants of antibiotic prescribing.ResultsNHS-DPPD practices prescribed an average of 576.1 antibiotics per 1000 patients per year (329.9 at the 5th percentile and 808.7 at the 95th percentile). The levels of prescribing of antibiotics and other medicines were strongly correlated. Practices with high levels of prescribing of other medicines (a rate of 27 159.8 at the 95th percentile) prescribed 80% more antibiotics than low-prescribing practices (rate of 8815.9 at the 5th percentile). After adjustment, NHS-DPPD practices with high prescribing of other medicines gave 60% more antibiotic prescriptions than low-prescribing practices (corresponding to higher prescribing of 276.3 antibiotics per 1000 patients per year). Prescribing of non-opioid painkillers and benzodiazepines were also strong indicators of the level of antibiotic prescribing. General prescribing levels were a much stronger driver for antibiotic prescribing than other risk factors, such as deprivation.ConclusionThe propensity of GPs to prescribe medications generally is an important driver for antibiotic prescribing. Interventions that aim to optimise antibiotic prescribing will need to target general prescribing behaviours, in addition to specifically targeting antibiotics.

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