Background:
Little is known about the clinical management of patients in primary care following self-harm.
Methods:
A 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.
Results:
Among 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.
Conclusions:
A 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.
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.
Code | Description | Entity type | Coding System (Multilex) | Category |
---|---|---|---|---|
39801020 | Zimovane 7.5mg tablets (Lexon (UK) Ltd) | res36: Anxiolitics | Multilex | drug |
479021 | Zopiclone 3.75mg/5ml oral solution | res36: Anxiolitics | Multilex | drug |
59209020 | Zopiclone 7.5mg tablets (Actavis UK Ltd) | res36: Anxiolitics | Multilex | drug |
59210020 | Zopiclone 3.75mg tablets (Actavis UK Ltd) | res36: Anxiolitics | Multilex | drug |
59236020 | Zopiclone 3.75mg tablets (IVAX Pharmaceuticals UK Ltd) | res36: Anxiolitics | Multilex | drug |
59237020 | Zopiclone 7.5mg tablets (IVAX Pharmaceuticals UK Ltd) | res36: Anxiolitics | Multilex | drug |
59593020 | Zopiclone 3.75mg tablets (Teva UK Ltd) | res36: Anxiolitics | Multilex | drug |
59594020 | Zopiclone 7.5mg tablets (Teva UK Ltd) | res36: Anxiolitics | Multilex | drug |
59784020 | Zopiclone 7.5mg tablets (Generics (UK) Ltd) | res36: Anxiolitics | Multilex | drug |
59785020 | Zopiclone 3.75mg tablets (Generics (UK) Ltd) | res36: Anxiolitics | Multilex | drug |
60509020 | Zopiclone 3.75mg tablets (A A H Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
60510020 | Zopiclone 7.5mg tablets (A A H Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
62715020 | Zopiclone 7.5mg tablets (Sandoz Ltd) | res36: Anxiolitics | Multilex | drug |
63436020 | Zopiclone 7.5mg tablets (Kent Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
63765020 | Zopiclone 7.5mg tablets (PLIVA Pharma Ltd) | res36: Anxiolitics | Multilex | drug |
63881020 | Zolpidem 5mg Tablet (Winthrop Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
63882020 | Zolpidem 10mg Tablet (Winthrop Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
64484020 | Zolpidem 5mg tablets (Teva UK Ltd) | res36: Anxiolitics | Multilex | drug |
64487020 | Zolpidem 10mg tablets (Teva UK Ltd) | res36: Anxiolitics | Multilex | drug |
64733020 | Zolpidem 5mg tablets (A A H Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
64738020 | Zolpidem 10mg tablets (A A H Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
65546020 | Zopiclone 3.75mg tablets (Kent Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
65832020 | Zolpidem 5mg tablets (IVAX Pharmaceuticals UK Ltd) | res36: Anxiolitics | Multilex | drug |
65835020 | Zolpidem 10mg tablets (IVAX Pharmaceuticals UK Ltd) | res36: Anxiolitics | Multilex | drug |
66946020 | Zolpidem 10mg tablets (Generics (UK) Ltd) | res36: Anxiolitics | Multilex | drug |
72408020 | Zimovane 7.5mg tablets (Sanofi) | res36: Anxiolitics | Multilex | drug |
72416020 | Zopiclone 7.5mg tablets | res36: Anxiolitics | Multilex | drug |
72417020 | Zopiclone 3.75mg tablets | res36: Anxiolitics | Multilex | drug |
75692020 | Zolpidem 5mg tablets | res36: Anxiolitics | Multilex | drug |
75693020 | Zolpidem 10mg tablets | res36: Anxiolitics | Multilex | drug |
75696020 | Stilnoct 5mg tablets (Sanofi) | res36: Anxiolitics | Multilex | drug |
75697020 | Stilnoct 10mg tablets (Sanofi) | res36: Anxiolitics | Multilex | drug |
83069020 | Zimovane LS 3.75mg tablets (Sanofi) | res36: Anxiolitics | Multilex | drug |
85821020 | Zileze 3.75 tablets (Opus Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
85822020 | Zileze 7.5 tablets (Opus Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
86240020 | Zaleplon 5mg capsules | res36: Anxiolitics | Multilex | drug |
86241020 | Zaleplon 10mg capsules | res36: Anxiolitics | Multilex | drug |
86243020 | Sonata 5mg capsules (Meda Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
86244020 | Sonata 10mg capsules (Meda Pharmaceuticals Ltd) | res36: Anxiolitics | Multilex | drug |
91009020 | Zopiclone 3.75mg/5ml oral suspension | res36: Anxiolitics | Multilex | drug |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH363/version/726/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH363/version/726/detail/?format=json |
R Package |
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To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH363/version/726/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH363/version/726/export/codes/?format=json |
CSV | site_root/phenotypes/PH363/version/726/export/codes/ |
R Package |
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Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
726 | Anxiolitics | ieuan.scanlon | 2021-10-06 | currently shown |
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