scholarly journals Weight loss as a predictor of cancer and serious disease in primary care: an ISAC-approved CPRD protocol for a retrospective cohort study using routinely collected primary care data from the UK

Author(s):  
B. D. Nicholson ◽  
P. Aveyard ◽  
F. D. R. Hobbs ◽  
M. Smith ◽  
A. Fuller ◽  
...  
2009 ◽  
Vol 41 (7) ◽  
pp. 490-496 ◽  
Author(s):  
Ronan P. Ryan ◽  
Richard J. McManus ◽  
Jonathan Mant ◽  
John A. A. Macleod ◽  
F. D. Richard Hobbs

2017 ◽  
Vol 67 (657) ◽  
pp. e300-e305 ◽  
Author(s):  
Lavanya Diwakar ◽  
Carole Cummins ◽  
Ronan Ryan ◽  
Tom Marshall ◽  
Tracy Roberts

BackgroundAdrenaline auto-injectors (AAI) should be provided to individuals considered to be at high risk of anaphylaxis. There is some evidence that the rate of AAI prescription is increasing, but the true extent has not been previously quantified.Aim To estimate the trends in annual GP-issued prescriptions for AAI among UK children between 2000 and 2012.Design and setting Retrospective cohort study using data from primary care practices that contributed to The Health Improvement Network (THIN) database.MethodChildren and young people aged between 0–17 years of age with a prescription for AAIs were identified, and annual AAI device prescription rates were estimated using Stata (version 12).ResultsA total of 1.06 million UK children were identified, providing 5.1 million person years of follow-up data. Overall, 23 837 children were deemed high risk by their GPs, and were prescribed 98 737 AAI devices. This equates to 4.67 children (95% confidence interval [CI] = 4.66 to 4.69), and 19.4 (95% CI = 19.2 to 19.5) devices per 1000 person years. Between 2000 and 2012, there has been a 355% increase in the number of children prescribed devices, and a 506% increase in the total number of AAI devices prescribed per 1000 person years in the UK. The number of devices issued per high-risk child during this period has also increased by 33%.ConclusionThe number of children being prescribed AAI devices and the number of devices being prescribed in UK primary care between 2000 and 2012 has significantly increased. A discussion to promote rational prescribing of AAIs in the NHS is needed.


BJGP Open ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. bjgpopen20X101083
Author(s):  
Adam McDermott ◽  
Emily Sanderson ◽  
Christopher Metcalfe ◽  
Rebecca Barnes ◽  
Clare Thomas ◽  
...  

BackgroundFrequent attenders (FAs) in primary care receive considerable resources with uncertain benefit. Only some FAs attend persistently. Modestly successful models have been built to predict persistent attendance. Nevertheless, an association between relational continuity of care and persistent frequent attendance remains unclear, and could be important considering both the UK government and Royal College of General Practitioner’s (RCGP) aim of improving continuity.AimTo identify predictive measures (including continuity) for persistent frequent attendance that may be modified in future interventions.Design & settingThis is a retrospective cohort study sampling 35 926 adult patients registered in seven Bristol practices.MethodThe top 3% (1227) of patients by frequency of GP consultations over 6 months were classed as FAs. Individual relational continuity was measured over the same period using the Usual Provider Continuity (UPC) index. Attendance change was calculated for the following 6 months. Multivariable logistic regression analysis was used to determine variables that predicted attendance change.ResultsFAs were on average 8.41 years older (difference 95% confidence interval [CI] = 7.33 to 9.50, P<0.001) and more likely to be female (65.36% versus 57.88%) than non-FAs. In total, 79.30% of FAs decreased attendance over the subsequent 6 months. No association was found between continuity and subsequent attendance. Increasing age was associated with maintained frequent attendance.ConclusionContinuity does not predict change in frequent attendance. In addition to improving continuity, recent government policy is focused on increasing primary care access. If both aims are achieved it will be interesting to observe any effect on frequent attendance.


Vaccine ◽  
2018 ◽  
Vol 36 (46) ◽  
pp. 7105-7111 ◽  
Author(s):  
Ian Matthews ◽  
Xiaoyan Lu ◽  
Hazel Dawson ◽  
Hélène Bricout ◽  
Helen O'Hanlon ◽  
...  

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