[ { "phenotype_id": "PH363", "phenotype_version_id": 726, "name": "Anxiolitics", "definition": "Background: \n\nLittle is known about the clinical management of patients in primary care following self-harm.\n\n\nMethods: \n\nA descriptive cohort study using data from 684 UK general practices that contributed to the Clinical Practice Research Datalink (CPRD) during 2001-2013. We identified 49,970 patients with a self-harm episode, 41,500 of whom had one complete year of follow-up.\n\n\nResults: \n\nAmong those with complete follow-up, 26,065 (62.8%, 62.3-63.3) were prescribed psychotropic medication and 6318 (15.2%, 14.9-15.6) were referred to mental health services; 4105 (9.9%, CI 9.6-10.2) were medicated without an antecedent psychiatric diagnosis or referral, and 4,506 (10.9%, CI 10.6-11.2) had a diagnosis but were not subsequently medicated or referred. Patients registered at practices in the most deprived localities were 27.1% (CI 21.5-32.2) less likely to be referred than those in the least deprived. Despite a specifically flagged NICE 'Do not do' recommendation in 2011 against prescribing tricyclic antidepressants following self-harm because of their potentially lethal toxicity in overdose, 8.8% (CI 7.8-9.8) of individuals were issued a prescription in the subsequent year. The percentage prescribed Citalopram, an SSRI antidepressant with higher toxicity in overdose, fell sharply during 2012/2013 in the aftermath of a Medicines and Healthcare products Regulatory Agency (MHRA) safety alert issued in 2011.\n\n\nConclusions: \n\nA relatively small percentage of these vulnerable patients are referred to mental health services, and reduced likelihood of referral in more deprived localities reflects a marked health inequality. National clinical guidelines have not yet been effective in reducing rates of tricyclic antidepressant prescribing for this high-risk group.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenant, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb, Clinical management following self-harm in a UK-wide primary care cohort. Journal of Affective Disorders, 197(2016) 182-188, 2016." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:15:46.624891Z", "author": "Matthew J Carr, Darren M Ashscroft, Evangelos Kontopantelis, David While, Yvonne Awenant, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:15:46.624920Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Drug", "value": "3" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 } ], "coding_system": [ { "name": "Multilex codes", "value": 16 } ], "event_date_range": "01/01/2001 - 31/12/2012", "concept_information": [ { "concept_id": 1692, "concept_version_id": 4522, "concept_name": "Anxiolitics - Primary Care", "coding_system": { "id": 16, "name": "Multilex codes", "description": "Multilex codes" }, "phenotype_id": "PH363", "phenotype_version_id": 726, "phenotype_name": "Anxiolitics", "code_attribute_header": [ "Entity type", "Coding System (Multilex)", "Category" ], "codes": [ { "code": "39801020", "description": "Zimovane 7.5mg tablets (Lexon (UK) Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "479021", "description": "Zopiclone 3.75mg/5ml oral solution", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59209020", "description": "Zopiclone 7.5mg tablets (Actavis UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59210020", "description": "Zopiclone 3.75mg tablets (Actavis UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59236020", "description": "Zopiclone 3.75mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59237020", "description": "Zopiclone 7.5mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59593020", "description": "Zopiclone 3.75mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59594020", "description": "Zopiclone 7.5mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59784020", "description": "Zopiclone 7.5mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "59785020", "description": "Zopiclone 3.75mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "60509020", "description": "Zopiclone 3.75mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "60510020", "description": "Zopiclone 7.5mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "62715020", "description": "Zopiclone 7.5mg tablets (Sandoz Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63436020", "description": "Zopiclone 7.5mg tablets (Kent Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63765020", "description": "Zopiclone 7.5mg tablets (PLIVA Pharma Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63881020", "description": "Zolpidem 5mg Tablet (Winthrop Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "63882020", "description": "Zolpidem 10mg Tablet (Winthrop Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64484020", "description": "Zolpidem 5mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64487020", "description": "Zolpidem 10mg tablets (Teva UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64733020", "description": "Zolpidem 5mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "64738020", "description": "Zolpidem 10mg tablets (A A H Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65546020", "description": "Zopiclone 3.75mg tablets (Kent Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65832020", "description": "Zolpidem 5mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "65835020", "description": "Zolpidem 10mg tablets (IVAX Pharmaceuticals UK Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "66946020", "description": "Zolpidem 10mg tablets (Generics (UK) Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72408020", "description": "Zimovane 7.5mg tablets (Sanofi)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72416020", "description": "Zopiclone 7.5mg tablets", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "72417020", "description": "Zopiclone 3.75mg tablets", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75692020", "description": "Zolpidem 5mg tablets", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75693020", "description": "Zolpidem 10mg tablets", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75696020", "description": "Stilnoct 5mg tablets (Sanofi)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "75697020", "description": "Stilnoct 10mg tablets (Sanofi)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "83069020", "description": "Zimovane LS 3.75mg tablets (Sanofi)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "85821020", "description": "Zileze 3.75 tablets (Opus Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "85822020", "description": "Zileze 7.5 tablets (Opus Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86240020", "description": "Zaleplon 5mg capsules", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86241020", "description": "Zaleplon 10mg capsules", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86243020", "description": "Sonata 5mg capsules (Meda Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "86244020", "description": "Sonata 10mg capsules (Meda Pharmaceuticals Ltd)", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } }, { "code": "91009020", "description": "Zopiclone 3.75mg/5ml oral suspension", "attributes": { "Entity type": "res36: Anxiolitics", "Coding System (Multilex)": "Multilex", "Category": "drug" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/sjaw-a594", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 726, "version_name": "Anxiolitics", "version_date": "2021-10-06T16:15:46.646445Z", "is_published": true, "is_latest": true } ] } ]