Objectives Overutilisation of antibiotics may contribute to the emergence antimicrobial drug resistance, a growing international concern. This study aimed analyse performance UK general practices with respect antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults. Setting Data are reported 568 contributing Clinical Practice Research Datalink. Participants were adults aged 18–59 years. Consultations identified acute upper RTIs including colds, cough,...

<b>Objective</b> To evaluate the association between alarm symptoms and subsequent diagnosis of cancer in a large population based study primary care. <b>Design</b> Cohort study. <b>Setting</b> UK General Practice Research Database. <b>Patients</b> 762 325 patients aged 15 years older, registered with 128 general practices 1994 2000. First occurrences haematuria, haemoptysis, dysphagia, rectal bleeding were identified no previous diagnosis.. <b>Main outcome measure</b> Positive predictive...

Objective To determine whether the incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial and Lemierre’s syndrome is higher in general practices that prescribe fewer antibiotics for self limiting respiratory tract infections (RTIs). Design Cohort study. Setting 610 UK from Clinical Practice Research Datalink. Participants Registered patients with 45.5 million person years follow-up 2005 to 2014. Exposures Standardised proportion RTI consultations...

Objective. Relapsing polychondritis is a rare disease characterized by cartilage inflammation. Our aim was to estimate the incidence, prevalence and mortality of relapsing describe clinical features in large population.

Abstract Objectives To evaluate the effectiveness and safety at population scale of electronically delivered prescribing feedback decision support interventions reducing antibiotic for self limiting respiratory tract infections. Design Open label, two arm, cluster randomised controlled trial. Setting UK general practices in Clinical Practice Research Datalink, between 11 November 2015 9 August 2016, with final follow-up on 2017. Participants 79 (582 675 patient years) (1:1) to antimicrobial...

Antibiotic prescribing by general practitioners (GPs) increased in the 1980s and peaked 1995. Prescribing volumes subsequently fell over a quarter between 1995 2000, mostly accounted for reduced antibiotic acute respiratory illnesses. We aimed to investigate changes consultation rates proportion of consultations with antibiotics prescribed different types tract infections.Data were derived from 108 UK practices, covering mean 642,685 patients, reporting data General Practice Research...

Epilepsy is an important cause of amenable mortality but risk factors for death in epilepsy are not well understood.To evaluate trends a large population and identify epilepsy.Nested case-control study the UK, using data from General Practice Research Database (GPRD) 1993 to 2007.Participants were included if they had ever been diagnosed with prescribed anticonvulsant drugs. Trends all-cause persons GPRD compared registrations as underlying cause. A nested was implemented compare...

Objective This study aimed to estimate the impact of deprivation on occurrence, health outcomes and care costs people with multiple morbidity in England. Methods Cohort UK Clinical Practice Research Datalink, using quintile (IMD2010) at individual postcode level. Incidence mortality from diabetes mellitus, coronary heart disease, stroke colorectal cancer, prevalence depression, were used define multidisease states. Costs use estimated for each state a two-part model. Results Data analysed...

<h3>PURPOSE</h3> This study aimed to implement a point-of-care cluster randomized trial using electronic health records. We evaluated the effectiveness of electronically delivered decision support tools at reducing antibiotic prescribing for respiratory tract infections in primary care. <h3>METHODS</h3> Family practices from England and Scotland participating Clinical Practice Research Datalink (CPRD) were included trial; 53 family allocated intervention 51 usual Patients aged 18 59 years...

Obesity is associated with depression. This study aimed to evaluate whether clinical depression reduced after bariatric surgery (BS).Obese adults who received BS procedures from 2002 2014 were sampled the UK Clinical Practice Research Datalink. An interrupted time series design, matched controls, was conducted three years before, a maximum of seven surgery. Controls for body mass index (BMI), age, gender and year procedure. defined as medical diagnosis recorded in year, or an antidepressant...

Objective This study aimed to estimate the association of frailty with incidence and mortality fractures at different sites in people aged over 80 years. Design Cohort study. Setting UK family practices from 2001 2014. Participants 265 195 registered participants years older. Measurements Frailty status classified into ‘fit’, ‘mild’, ‘moderate’ ‘severe’ frailty. Fractures, non-fragility fragility, including femur, pelvis, shoulder upper arm, forearm/wrist. Incidence fracture, within 90 days...

<h3>Background</h3> Our goal was to determine whether immunization is associated with the incidence of Guillain-Barré syndrome (GBS). <h3>Methods</h3> We analyzed data for all patients registered 253 general practices in United Kingdom General Practice Research Database from 1992 2000, a mean 1.8 million patients. identified new occurrences GBS and estimated age- sex-specific age-standardized rates. then determined date diagnosis made within 42 days any relative risk following after...

<b>Objective</b> To evaluate the predictive value of alarm symptoms for specified non-cancer diagnoses and cancer in primary care. <b>Design</b> Cohort study using general practice research database. <b>Setting</b> 128 practices UK contributing data, 1994-2000. <b>Participants</b> 762 325 patients aged 15 or older. <b>Main outcome measures</b> Up to pre-specified, associated with four (haematuria, haemoptysis, dysphagia, rectal bleeding) at 90 days three years after first recorded symptom....

Electronic patient records from primary care databases are increasingly used in public health and services research but methods to identify cases with disease not well described. This study aimed evaluate the relevance of different codes for identification acute stroke a database, trends use over time.Data were obtained General Practice Research Database 1997 2006. All subjects had minimum 24 months up-to-standard record before first recorded diagnosis. Initially, we identified using...

Background This study aimed to determine whether depression in patients with long-term conditions is associated the number of morbidities or type co-morbidity. Method A cohort 299 912 participants aged 30–100 years. The prevalence depression, rates health-care utilization and costs were evaluated relation diagnoses diabetes mellitus (DM), coronary heart disease (CHD), stroke colorectal cancer. Results age-standardized was 7% men 14% women no morbidity. frequency increased single including DM...

Irritable bowel syndrome is a common problem known to have complex relationship with psychological disorders and other physical symptoms. Little information, however, available concerning comorbidity in irritable patients studied over an extended period.To evaluate morbidity 2 years before during 6 after the time of diagnosis incident cases control subjects.A matched cohort study was implemented 123 general practices using General Practice Research Database. (n = 1827) controls 3654) were...

The purpose of this study was to test the hypothesis that changing utilization lipid-lowering, antihypertensive, and oral hypoglycemic drugs may be associated with trends in all-cause mortality men women type 2 diabetes.This a cohort 197 general practices U.K. General Practice Research Database including 48,579 subjects diabetes first diagnosed between 1996 2006. Measures included prescription hypoglycemic, antihypertensive drugs.From 2006, incidence increased mean age at diagnosis declined...

ABSTRACT Background This study aimed to evaluate whether treatment with sodium valproate (SV) was associated reduced risk of stroke or myocardial infarction (MI). Methods Electronic health records data were extracted from Clinical Practice Research Database for participants ever diagnosed epilepsy and prescribed antiepileptic drugs. A nested case–control implemented cases incident non‐haemorrhagic controls matched sex, year birth, start date (ratio 1:6). second MI as outcome. The main...

statin use over the age of 80 years is weakly evidence-based. This study aimed to estimate rates inception and deprescribing by frailty level in people aged or older. a cohort 212,566 participants ≥80 was sampled from UK Clinical Practice Research Datalink. Statin defined as first-ever prescription non-statin user; last ever more than 6 months before end participant records. Rates were estimated time-to-event framework allowing for mortality competing risk. Co-variates age, gender, category...

This study aimed to use primary care electronic health records evaluate the epidemiology of bariatric surgery in UK. A cohort comprising all obese patients with a surgical procedure was drawn from Clinical Practice Research Datalink (CPRD). Rates were estimated using registered CPRD population as denominator. There 3039 adult first procedures between 2002 and 2014, including laparoscopic adjustable gastric banding (LAGB), 1297; bypass (GBP), 1265; sleeve gastrectomy (SG), 477. Annual...

Objectives To evaluate the coding, recording and incidence of coronary heart disease (CHD) in primary care electronic medical records. Methods Data were drawn from UK General Practice Research Database. Analyses evaluated occurrence 271 READ diagnostic codes, including categories for 'Angina', 'Myocardial Infarction', 'Coronary Artery Bypass Grafting' (CABG), 'percutaneous transluminal angioplasty' (PCTA) 'Other Coronary Heart Disease'. Time-to-event analyses implemented to occurrences...

This study evaluated socioeconomic inequality in morbid obesity (body mass index, BMI ≥40 kg/m2) through an analysis of population health survey data the United States (US) and England (UK).We analysed for National Health Nutrition Examination Survey 2011 to 2014. Age-adjusted odds ratios (AOR) were used evaluate income- education-inequality.There 26,898 eligible UK 10,628 US participants. Morbid was more frequent women than men, higher (men: US, 4.8%; UK, 1.7%; 9.6%; 3.7%). In showed graded...