A5004722008- Atrial Fibrillation Management and Outcomes
- Acute Ischemic Stroke Management
- Lipoproteins and Cardiovascular Health
- Venous Thromboembolism Diagnosis and Management
- Cardiac Arrhythmias and Treatments
- Acute Myocardial Infarction Research
- Medication Adherence and Compliance
- Chronic Disease Management Strategies
- Digital Mental Health Interventions
- COVID-19 Clinical Research Studies
- COVID-19 and healthcare impacts
- Mobile Health and mHealth Applications
- Blood Pressure and Hypertension Studies
- Antiplatelet Therapy and Cardiovascular Diseases
- Health Systems, Economic Evaluations, Quality of Life
- Diabetes Treatment and Management
- Cardiac electrophysiology and arrhythmias
- Healthcare Systems and Public Health
- Pharmacological Effects and Toxicity Studies
- Peripheral Artery Disease Management
- Innovations in Medical Education
- Health disparities and outcomes
- Epilepsy research and treatment
- Frailty in Older Adults
- Nanoplatforms for cancer theranostics
Swansea University
2018-2024
Hywel Dda University Health Board
2023-2024
Swansea Bay University Health Board
2019-2023
Health Data Research UK
2019-2022
Morriston Hospital
2019-2021
University of Auckland
2013
Summary Objective This study was undertaken to determine whether epilepsy and antiepileptic drugs (including enzyme‐inducing non‐enzyme‐inducing drugs) are associated with major cardiovascular events using population‐level, routinely collected data. Methods Using anonymized, collected, health care data in Wales, UK, we performed a retrospective matched cohort (2003–2017) of adults prescribed an drug. Controls were replacement on age, gender, deprivation quintile, year entry into the study....
Abstract Aims European clinical guidelines recommend that patients with atherosclerotic cardiovascular disease (ASCVD), including ischaemic heart (IHD), stroke, and peripheral arterial (PAD), are prescribed lipid lowering treatment (LLT) treated to target low-density lipoprotein cholesterol (LDL-C) levels. This study aimed document trends in ASCVD, treatment, monitoring, achievement of LDL-C. Methods results A retrospective observational population was performed using linked healthcare data...
Abstract Aims European Society of Cardiology/European Atherosclerosis 2019 guidelines recommend more aggressive lipid targets in high- and very high-risk patients the addition adjuvant treatments to statins uncontrolled patients. We aimed assess (a) achievement prior new (b) lipid-lowering therapy prescribing a nationwide cohort Methods conducted retrospective observational population study using linked health data undergoing percutaneous coronary intervention (2012–2017). Follow-up was for...
Abstract Objective To determine atrial fibrillation (AF) prevalence and temporal trends, examine associations between AF risk of adverse health outcomes in older care home residents. Methods Retrospective cohort study using anonymised linked data from the Secure Anonymised Information Linkage Databank on CARE residents Wales with (SAIL CARE-AF) 2003 2018. Fine-Gray competing models were used to estimate mortality as a risk. Cox regression analyses mortality. Results There 86,602 (median age...
A key requirement for longitudinal studies using routinely-collected health data is to be able measure what individuals are present in the datasets used, and over time period. Individuals can enter leave covered population of administrative a variety reasons, including both life events characteristics themselves. An automated, customizable method determining individuals' presence was developed primary care dataset Swansea University's SAIL Databank. The covers only portion Wales, with 76%...
Abstract Objectives To estimate the impact of COVID-19 pandemic on cardiovascular disease (CVD) and CVD management using routinely collected medication data as a proxy. Design Descriptive interrupted time series analysis anonymised individual-level population-scale for 1.32 billion records dispensed medications across 15.8 million individuals in England, Scotland Wales. Setting Community with 100% coverage from Wales, plus primary care prescribed England (including 98% English general...
BackgroundPopulation-level information on dispensed medication provides insight the distribution of treated morbidities, particularly if linked to other population-scale data at an individual-level. ObjectiveTo evaluate impact COVID-19 dispensing patterns medications. MethodsRetrospective observational study using population-scale, individual-level records in Wales, UK. Total drug items for population between 1st January 2016 and 31st December 2019 (3-years, pre-COVID-19) were compared 2020...
Abstract Background The Atrial fibrillation Better Care (ABC) pathway is the gold-standard approach to atrial (AF) management, but effect of implementation on health outcomes in care home residents unknown. Objective To examine associations between ABC adherence and stroke, transient ischaemic attack, cardiovascular hospitalisation, major bleeding, mortality a composite all these residents. Methods A retrospective cohort study older (≥65 years) Wales with AF was conducted 1 January 2003 31...
Background Treatment decisions about oral anticoagulants (OACs) for atrial fibrillation (AF) are complex in older care home residents. Aim To explore factors associated with OAC prescription. Design and setting Retrospective cohort study set homes Wales, UK, listed the Care Inspectorate Wales Registry 2017/18. Method Analysis of anonymised individual-level electronic health administrative data was carried out on people aged ≥65 years entering a between 1 January 2003 31 December 2018,...
Abstract Aims In patients with non-valvular atrial fibrillation prescribed warfarin, the UK National Institute of Health and Care Excellence (NICE) defines poor anticoagulation as a time in therapeutic range (TTR) <65%, any two international normalized ratios (INRs) within 6-month period ≤1.5 (‘low’), INRs ≥5 6 months, or INR ≥8 (‘high’). Our objectives were to (i) quantify number control (ii) describe demographic clinical characteristics associated control. Method results Linked...
Abstract Aims Atrial fibrillation (AF) is an important risk factor for stroke, which commonly asymptomatic, particularly in older patients, and often undetected until cardiovascular events occur. Development of novel technology has helped to improve detection AF. However, the longer-term benefit systematic electrocardiogram (ECG) screening on outcomes unclear. Methods results In original REHEARSE-AF study, patients were randomized twice-weekly portable (iECG) assessment or routine care....
Background Early discontinuation of P2Y12 antagonists post-percutaneous coronary intervention may increase risk stent thrombosis or nonstent recurrent myocardial infarction. Our aims were to (1) analyze the early rate intervention, (2) explore factors associated with discontinuation, and (3) major adverse cardiovascular events (death, acute syndrome, revascularization, stroke) from a prespecified prescribing instruction 1 year. Method Results We studied 2090 patients (2011-2015) who...
To explore differences in the use of lipid lowering therapy and/or achievement guideline targets patients with and without prior depression influence sex very high-risk coronary patients.A retrospective observational cohort study was conducted using individual-level linked electronic health record data who underwent percutaneous intervention (2012-2017) Wales. The comprised 13,781 (27.4% female), 26.1% having depression. Lipid levels were recorded 10,050 whom 25% had History independently...
Abstract Background United Kingdom guidelines (NICE, NG106) for suspected chronic heart failure (HF) recommend that NT pro-BNP is performed as a first-line test. The result also used to triage individuals; when <400ng/L, diagnosis of HF less likely, echocardiography (echo) and specialist assessment should be within 6 weeks the 400-2000ng/L, 2 if >2000ng/L. How accurately this guidance followed in clinical practice Wales not known. Purpose To examine how current diagnostic...
Abstract Background Heart failure (HF) is associated with high healthcare resource use and mortality. Most of the evidence focuses on hospital admission data. The impact primary care interactions outpatient attendance less well described, but this information important in understanding utilisation, patient pathways, planning services. Purpose To examine how a diagnosis HF impacts outcomes for older people Wales. Methods We conducted retrospective, population-level, observational study using...
Abstract Background Older care home residents are a high-risk group of people with atrial fibrillation (AF) who under-represented in clinical trials. Improved understanding AF epidemiology and management this population is paramount for health social organisations to strategically plan services. Purpose To determine the trends prevalence compare adverse outcomes older aged ≥65 years compared those without AF. Methods Retrospective cohort study entering between 2003–2018 using nationwide,...
Guidelines recommend anticoagulation (AC) in atrial fibrillation (AF) to reduce stroke and systemic embolism (SSE) risk; however, implementation has been slow across many populations. This study aimed quantify the potential impact of changing prevalence AF, associated risk, AC prescribing on SSE hospitalizations death.
Abstract Background Medication prescribing and dispensing often regarded as one of the most effective ways to manage improve population health. Prescribed dispensed medications can be monitored through data linkage for each patient. We hypothesised that changes in patient care resulting from COVID-19, changed way patients access their prescribed medication. Objective To develop an efficient approach evaluation impact COVID-19 on drug patterns. Methods Retrospective observational study using...
Abstract Background Medication prescribing and dispensing often regarded as one of the most effective ways to manage improve population health. Prescribed dispensed medications can be monitored through data linkage for each patient. We hypothesised that changes in patient care resulting from COVID-19, changed way patients access their prescribed medication. Objective To develop an efficient approach evaluation impact COVID-19 on drug patterns. Methods Retrospective observational study using...