scholarly journals The Long-Term Impact of Vaginal Surgical Mesh Devices in UK Primary Care: A Cohort Study in the Clinical Practice Research Datalink

2021 ◽  
Vol Volume 13 ◽  
pp. 1167-1180
Author(s):  
Emily McFadden ◽  
Sarah Lay-Flurrie ◽  
Constantinos Koshiaris ◽  
Georgia C Richards ◽  
Carl Heneghan
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Clinical Practice ◽  
Surgical Mesh ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Long Term Impact

scholarly journals Association of guideline and policy changes with incidence of lifestyle advice and treatment for uncomplicated mild hypertension in primary care: a longitudinal cohort study in the Clinical Practice Research Datalink

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021827 ◽  
Author(s):  
James P Sheppard ◽  
Sarah Stevens ◽  
Richard J Stevens ◽  
Jonathan Mant ◽  
Una Martin ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Clinical Practice ◽  
Mild Hypertension ◽  
Secular Trends ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Lifestyle Advice ◽  
Policy Changes ◽  
Cvd Risk

ObjectivesEvidence to support initiation of pharmacological treatment in patients with uncomplicated (low risk) mild hypertension is inconclusive. As such, clinical guidelines are contradictory and healthcare policy has changed regularly. The aim of this study was to determine the incidence of lifestyle advice and drug therapy in this population and whether secular trends were associated with policy changes.DesignLongitudinal cohort study.SettingPrimary care practices contributing to the Clinical Practice Research Datalink in England.ParticipantsData were extracted from the linked electronic health records of patients aged 18–74 years, with stage 1 hypertension (blood pressure between 140/90 and 159/99 mm Hg), no cardiovascular disease (CVD) risk factors and no treatment, from 1998 to 2015. Patients exited if follow-up records became unavailable, they progressed to stage 2 hypertension, developed a CVD risk factor or received lifestyle advice/treatment.Primary outcome measuresThe association between policy changes and incidence of lifestyle advice or treatment, examined using an interrupted time-series analysis.ResultsA total of 108 843 patients were defined as having uncomplicated mild hypertension (mean age 51.9±12.9 years, 60.0% female). Patientsspent a median 2.6 years (IQR 0.9–5.5) in the study, after which 12.2% (95% CI 12.0% to 12.4%) were given lifestyle advice, 29.9% (95% CI 29.7% to 30.2%) were prescribed medication and 19.4% (95% CI 19.2% to 19.6%) were given both. The introduction of the quality outcomes framework (QOF) and subsequent changes to QOF indicators were followed by significant increases in the incidence of lifestyle advice. Treatment prescriptions decreased slightly over time, but were not associated with policy changes.ConclusionsDespite secular trends that accord with UK guidance, many patients are still prescribed treatment for mild hypertension. Adequately powered studies are needed to determine if this is appropriate.

scholarly journals Primary care consultation rates among people with and without severe mental illness: a UK cohort study using the Clinical Practice Research Datalink

BMJ Open ◽  
2015 ◽  
Vol 5 (12) ◽  
pp. e008650 ◽  
Author(s):  
Evangelos Kontopantelis ◽  
Ivan Olier ◽  
Claire Planner ◽  
David Reeves ◽  
Darren M Ashcroft ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Cohort Study ◽  
Clinical Practice ◽  
Severe Mental Illness ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Primary Care Consultation ◽  
Care Consultation

scholarly journals Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (5) ◽  
pp. e020827 ◽  
Author(s):  
Rachael Williams ◽  
Tjeerd-Pieter van Staa ◽  
Arlene M Gallagher ◽  
Tarek Hammad ◽  
Hubert G M Leufkens ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Study ◽  
Clinical Practice ◽  
Hospital Admission ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Primary Care Data ◽  
Admission Data
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