Association between opioid‐related deaths and persistent opioid prescribing in primary care in England: a nested case‐control study

2021 ◽  
Author(s):  
Teng‐Chou Chen ◽  
Roger David Knaggs ◽  
Li‐Chia Chen
Keyword(s):  
Primary Care ◽  
Case Control Study ◽  
Case Control ◽  
Opioid Prescribing ◽  
Nested Case Control ◽  
Control Study

scholarly journals Exposure to domestic violence and abuse and consultations for emergency contraception: nested case-control study in a UK primary care dataset

2018 ◽  
Vol 69 (680) ◽  
pp. e199-e207 ◽  
Author(s):  
Joni Jackson ◽  
Natalia V Lewis ◽  
Gene S Feder ◽  
Penny Whiting ◽  
Timothy Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Domestic Violence ◽  
General Practice ◽  
Emergency Contraception ◽  
Case Control Study ◽  
Case Control ◽  
Exposure To Domestic Violence ◽  
Nested Case Control ◽  
Domestic Violence And Abuse ◽  
Control Study

BackgroundEvidence of an association between exposure to domestic violence and abuse (DVA) and use of emergency contraception (EC) is lacking in the UK.AimTo quantify the association between exposure to DVA and consultations for EC in general practice.Design and settingNested case-control study in UK general practice.MethodUsing the Clinical Practice Research Datalink, the authors identified all women all women aged 15–49 years registered with a GP between 1 January 2011 and 31 December 2016. Cases with consultations for EC (n = 43 570) were each matched on age and GP against four controls with no consultations for EC (n = 174 280). The authors calculated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between exposure to DVA in the previous year and consultations for EC. Covariates included age, ethnicity, socioeconomic status, pregnancy, children, alcohol misuse, and depression.ResultsWomen exposed to DVA were 2.06 times more likely to have a consultation for EC than unexposed women (95% CI = 1.64 to 2.61). Women aged 25–39 years with exposure to DVA were 2.8 times more likely to have a consultation for EC, compared with unexposed women (95% CI = 2.08 to 3.75). The authors found some evidence of an independent effect of exposure to DVA on the number of consultations for EC (OR 1.48, 95% CI = 0.99 to 2.21).ConclusionA request for EC in general practice can indicate possible exposure to DVA. Primary care consultation for EC is a relevant context for identifying and responding to DVA as recommended by the World Health Organization and National Institute for Health and Care Excellence guidelines. DVA training for providers of EC should include this new evidence.

scholarly journals Features of childhood cancer in primary care: a population-based nested case-control study

2012 ◽  
Vol 97 (Suppl 1) ◽  
pp. A5.1-A5
Author(s):  
RM Dommett ◽  
TR Redaniel ◽  
MCG Stevens ◽  
W Hamilton ◽  
RM Martin
Keyword(s):  
Primary Care ◽  
Childhood Cancer ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Nested Case Control ◽  
Control Study

scholarly journals Clinical features in primary care electronic records before diagnosis of Ankylosing Spondylitis: a nested case-control study.

2019 ◽  
Author(s):  
Mohammed Talha Bashir ◽  
Lisa Iversen ◽  
Christopher Burton
Keyword(s):  
Primary Care ◽  
Clinical Features ◽  
Diagnostic Tests ◽  
Case Control Study ◽  
Case Control ◽  
Electronic Records ◽  
Large Joint ◽  
Axial Pain ◽  
Nested Case Control ◽  
Control Study

Abstract Background Ankylosing spondylitis (AS) often has a long period from first symptom presentation to diagnosis. We examined the occurrence of symptoms, prescriptions and diagnostic tests in primary care electronic records over time prior to a diagnosis of AS.Methods Nested case-control study using anonymised primary care electronic health records from Scotland. Cases were 100 adults with a first diagnosis of AS between 1994 and 2010. Controls were matched for age, sex and GP practice: (a) 400 randomly selected adults (b) 236 adults whose records contained codes indicating spinal conditions or symptoms. We extracted clinical features (symptoms, AS-related disorders, prescriptions and diagnostic tests). Conditional logistic regression was used to examine the association between clinical features (both individually and in combinations) and diagnosis of AS. We examined the associations between clinical features and diagnosis over time prior to diagnosis.Results Several new composite pointers were predictive of AS: including distinct episodes of axial pain separated by more than 6 months (OR 3.7, 95% CI 1.8 to 7.5) and the co-occurrence of axial pain with either large joint symptoms (OR 2.7, 95% CI 1.1 to 6.3) or tendon symptoms within the same year (OR 3.6, 95% CI 1.3 to 10.3). Coded episodes of axial pain increased steadily over the three years before diagnosis. In contrast, large joint symptoms and enthesopathy showed little or no time trend prior to diagnosis.Conclusions We identified novel composite pointers to a diagnosis of AS in GP records. These may represent valuable targets for diagnostic support systems.

scholarly journals Shingles, Zostavax vaccination and risk of developing dementia: a nested case–control study—results from the UK Biobank cohort

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045871
Author(s):  
Artitaya Lophatananon ◽  
Krisztina Mekli ◽  
Rachel Cant ◽  
Alistair Burns ◽  
Curtis Dobson ◽  
...  
Keyword(s):  
Primary Care ◽  
Case Control Study ◽  
Case Control ◽  
Uk Biobank ◽  
Dementia Diagnosis ◽  
Study Results ◽  
The Uk ◽  
Nested Case Control ◽  
Incident Cases ◽  
Control Study

ObjectivesTo investigate the association between shingles and dementia, and between Zostavax vaccination and dementia.DesignNested case–control study.SettingsData were drawn from the UK Biobank cohort study with a total of 228 223 participants with Hospital Episodes Statistics and primary care linkage health records.ParticipantsThe analyses included 2378 incident dementia cases and 225 845 controls. Inclusion criteria for incident cases were a dementia diagnosis 3 years or more after the first assessment date derived from all sources including International Classification of Diseases (ICD)-10, ICD-9, self-report and primary care linkage records. Subjects with no dementia code from all sources were coded as controls. Both shingles and Zostavax vaccination were investigated for their association with dementia risk.ResultsThere was a small but non-significant increase in the risk of dementia in subjects with shingles diagnosed 3 years or more prior to dementia diagnosis (OR: 1.088 with 95% CI: 0.978 to 1.211). In those subjects who had had Zostavax vaccination, the risk of dementia significantly decreased (OR: 0.808 with 95% CI: 0.657 to 0.993).ConclusionA history of shingles was not associated with an increased risk of dementia. In subjects who were eligible for the immunisation and vaccinated with Zostavax, we saw reduced risk of developing dementia.

scholarly journals Epilepsy and mortality: a retrospective cohort analysis with a nested case–control study identifying causes and risk factors from primary care and linkage-derived data

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052841
Author(s):  
Gabriella Wojewodka ◽  
Martin C Gulliford ◽  
Mark Ashworth ◽  
Mark P Richardson ◽  
Leone Ridsdale
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
General Population ◽  
Cause Of Death ◽  
Retrospective Cohort ◽  
Case Control Study ◽  
Case Control ◽  
Factors Associated ◽  
Nested Case Control ◽  
Control Study

ObjectivesPeople with epilepsy (PWE) have a higher mortality rate than the general population. Epilepsy-related deaths have increased despite all-cause mortality decreasing in the general population pre-COVID-19. We hypothesised that clinical and lifestyle factors may identify people more at risk.DesignWe used a retrospective cohort study to explore cause of death and a nested case–control study to identify risk factors.SettingWe explored factors associated with mortality using primary care population data from 1 April 2004 to 31 March 2014. Data were obtained from the Clinical Practice Research Datalink which compiles anonymised patient data from primary care in the UK. Cause of death data was supplemented from the Office of National Statistics when available.ParticipantsThe analysis included 70 431 PWE, with 11 241 registered deaths.ResultsThe number of deaths within the database increased by 69% between the first and last year of the study. Epilepsy was considered as a contributing cause in approximately 45% of deaths of PWE under 35. Factors associated with increased risk of death included attendance at emergency departments and/or emergency admissions (OR 3.48, 95% CI 3.19 to 3.80), antiepileptic drug (AED) polytherapy (2 AEDs: OR 1.60, 95% CI 1.51 to 1.71; 3 AEDs: OR 2.06, 95% CI 1.86 to 2.29; 4+AEDs: OR 2.62, 95% CI 2.23 to 3.08), status epilepticus (OR 2.78, 95% CI 1.64 to 4.71), depression (OR 1.67, 95% CI 1.57 to 1.76) and injuries (OR 1.54, 95% CI 1.43 to 1.67). No seizures in the prior year (OR 0.52, 95% CI 0.41 to 0.65).ConclusionOur results add to existing evidence that deaths in epilepsy are increasing. Future studies could focus on identifying PWE at high risk and addressing them with clinical interventions or better self-management. Identifying specific risk factors for younger people should be a priority as epilepsy may be a factor in close to half of deaths of PWE under 35 years of age.

scholarly journals The Relationship between Asthma and Depression in Primary Care Patients: A Historical Cohort and Nested Case Control Study

PLoS ONE ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. e20750 ◽  
Author(s):  
Paul Walters ◽  
Peter Schofield ◽  
Louise Howard ◽  
Mark Ashworth ◽  
André Tylee
Keyword(s):  
Primary Care ◽  
Case Control Study ◽  
Case Control ◽  
Historical Cohort ◽  
Primary Care Patients ◽  
Nested Case Control ◽  
The Relationship ◽  
Control Study

scholarly journals Clinical features in primary care electronic records before diagnosis of Ankylosing Spondylitis: a nested case-control study.

2019 ◽  
Author(s):  
Mohammed Talha Bashir ◽  
Lisa Iversen ◽  
Christopher Burton
Keyword(s):  
Primary Care ◽  
Clinical Features ◽  
Diagnostic Tests ◽  
Case Control Study ◽  
Case Control ◽  
Electronic Records ◽  
Large Joint ◽  
Axial Pain ◽  
Nested Case Control ◽  
Control Study

Abstract Background Ankylosing spondylitis (AS) often has a long period from first symptom presentation to diagnosis. We examined the occurrence of symptoms, prescriptions and diagnostic tests in primary care electronic records over time prior to a diagnosis of AS.Methods Nested case-control study using anonymised primary care electronic health records from Scotland. Cases were 100 adults with a first diagnosis of AS between 1994 and 2010. Controls were matched for age, sex and GP practice: (a) 400 randomly selected adults (b) 236 adults whose records contained codes indicating spinal conditions or symptoms. We extracted clinical features (symptoms, AS-related disorders, prescriptions and diagnostic tests). Conditional logistic regression was used to examine the association between clinical features (both individually and in combinations) and diagnosis of AS. We examined the associations between clinical features and diagnosis over time prior to diagnosis.Results Several new composite pointers were predictive of AS: including distinct episodes of axial pain separated by more than 6 months (OR 3.7, 95% CI 1.8 to 7.5) and the co-occurrence of axial pain with either large joint symptoms (OR 2.7, 95% CI 1.1 to 6.3) or tendon symptoms within the same year (OR 3.6, 95% CI 1.3 to 10.3). Coded episodes of axial pain increased steadily over the three years before diagnosis. In contrast, large joint symptoms and enthesopathy showed little or no time trend prior to diagnosis.Conclusions We identified novel composite pointers to a diagnosis of AS in GP records. These may represent valuable targets for diagnostic support systems.

scholarly journals Clinical features in primary care electronic records before diagnosis of Ankylosing Spondylitis: a nested case-control study.

2020 ◽  
Author(s):  
Mohammed Talha Bashir ◽  
Lisa Iversen ◽  
Christopher Burton
Keyword(s):  
Primary Care ◽  
Clinical Features ◽  
Diagnostic Tests ◽  
Case Control Study ◽  
Case Control ◽  
Electronic Records ◽  
Axial Pain ◽  
Nested Case Control ◽  
Control Study ◽  
Over Time

Abstract Background Ankylosing spondylitis (AS) often has a long period from first symptom presentation to diagnosis. We examined the occurrence of symptoms, prescriptions and diagnostic tests in primary care electronic records over time prior to a diagnosis of AS.Methods Nested case-control study using anonymised primary care electronic health records from Scotland. Cases were 74 adults with a first diagnosis of AS between 2000 and 2010. Controls were matched for age, sex and GP practice: (a) 296 randomly selected adults (b) 169 adults whose records contained codes indicating spinal conditions or symptoms. We extracted clinical features (symptoms, AS-related disorders, prescriptions and diagnostic tests). Conditional logistic regression was used to examine the association between clinical features (both individually and in combinations) and diagnosis of AS. We examined the associations between clinical features and diagnosis over time prior to diagnosis.Results Several new composite pointers were predictive of AS: including distinct episodes of axial pain separated by more than 6 months (OR 12.7, 95% CI 4.7 to 34.6); the occurrence of axial pain with and tendon symptoms within the same year (OR 21.7, 95% CI 2.6 to 181.5); and the co-occurrence (within 30 days) of axial pain and a prescription for nonsteroidal anti-inflammatory drug (OR 10.4, 95%CI 4.9 to 22.1). Coded episodes of axial pain increased steadily over the three years before diagnosis. In contrast, large joint symptoms and enthesopathy showed little or no time trend prior to diagnosis. Conclusions We identified novel composite pointers to a diagnosis of AS in GP records. These may represent valuable targets for diagnostic support systems.

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