The database:
The CPRD is a large computerised database of anonymised primary care medical records. It contains complete patient information for participating practices, with the healthcare events (diagnoses, treatments, referrals, tests and prescriptions) recorded using coding systems (Read coding for diagnoses). Practice characteristics are described in detail elsewhere. The database is broadly representative of the UK population, although larger practices are over-represented. Practices need to meet prespecified data entry quality criteria to be defined as ‘up to research standard’, and for each study year, our main sample included all CPRD practices that were classed as such for the whole year. We also generated two data sets to test the sensitivity of our findings. First, we included all practices contributing data across the entire study period. Second, we included a subsample of 50 practices, representative of UK practices in terms of area deprivation, and practice list size.
Defining people with SMI and controls:
Information was extracted for the period 1 April 2000 to 31 March 2012 and aggregated into 12 yearly ‘bins’, to correspond with financial years 2000/2001–2011/2012. We used Read codes to identify the presence of SMI. First, we identified relevant keywords (or key-stubs) and codes, for example ‘paranoi’ and ‘E100.00’ (simple schizophrenia). Next, the CPRD was searched for codes that matched the list in either the code or the description field. Finally, the matched code list was reviewed by clinical experts and a final conservative list of codes was agreed. A similar process was used to define comorbidities (hypertension, asthma, hypothyroidism, osteoarthritis, chronic kidney disease, coronary heart disease, epilepsy, chronic obstructive pulmonary disease, cancer, stroke, heart failure, rheumatoid arthritis, dementia and psoriasis). All code lists we used are available from http://www.clinicalcodes.org. All conditions, bar asthma, were treated as unresolvable (ie, permanent). Within each year, all patients registered with a CPRD practice for the whole year and aged 18 or over were eligible for inclusion. The final SMI Read code list was used to identify cases of SMI, which were then grouped into three broad subcategories, in line with the diagnoses used when compiling primary care QOF SMI registers: schizophrenia; affective psychoses (bipolar disorder or other unspecified affective psychosis); other types of psychosis. In the event that an individual received more than one SMI diagnosis over the study period, we used the last available diagnosis to retrospectively ‘correct’ the original diagnosis (ie, we assumed that the latest diagnosis was the correct one). Within each year, each SMI case was then matched on age, sex and practice to five randomly selected patients not associated with SMI up until that time point. More details on the extraction of the cohort have been provided elsewhere,21 and a flow chart of the data extraction process is available in the online appendix figure A2.
Defining consultation type:
We defined a ‘consultation’ as involving direct contact between a patient and a healthcare professional within the primary care setting. We divided consultations into two main categories: face-to-face (our primary outcome), and by telephone (see online appendix table A1). We also constructed a third ‘other’ grouping of all other activities that are captured by the ‘consultation type’ codes within the CPRD. This includes mail/email contact, third party consultations (including referrals), secondary care episodes, other administrative tasks and consultations of unknown content. This group is highly heterogeneous and includes many activities that cannot be classed as consultations. However, we decided to use this grouping as an aggregate secondary outcome since it can potentially provide insight into the overall workload associated with patient care in the primary care context. We decided against breaking down the ‘other’ group in more subcategories as we are very doubtful regarding the reliability and across practice consistency of the coding within these ‘other’ categories. In instances where a patient had two or more consultations within a day, we conservatively assumed a single consultation took place, to reduce the likelihood of including duplicate records.
Evangelos Kontopantelis, Ivan Olier, Claire Panner, David Reeves, Darren M Ashcroft, Linda Gask, Tim Doran, Siobhan Reilly, Primary care consultation rates among people with and without severe mental illness a UK cohort study using the Clinical Practice Research Datalink. BMJ Open, 5 (e008650), 2015.
Code | Description | Entity type | Category | Coding System (Read) |
---|---|---|---|---|
66Ao.00 | Diabetes type 2 review | res21: DMII | diagnostic | Read |
66At100 | Type II diabetic dietary review | res21: DMII | diagnostic | Read |
66At111 | Type 2 diabetic dietary review | res21: DMII | diagnostic | Read |
C100112 | Non-insulin dependent diabetes mellitus | res21: DMII | diagnostic | Read |
C109.00 | Non-insulin dependent diabetes mellitus | res21: DMII | diagnostic | Read |
C109.11 | NIDDM - Non-insulin dependent diabetes mellitus | res21: DMII | diagnostic | Read |
C109.12 | Type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C109.13 | Type II diabetes mellitus | res21: DMII | diagnostic | Read |
C109000 | Non-insulin-dependent diabetes mellitus with renal comps | res21: DMII | diagnostic | Read |
C109011 | Type II diabetes mellitus with renal complications | res21: DMII | diagnostic | Read |
C109012 | Type 2 diabetes mellitus with renal complications | res21: DMII | diagnostic | Read |
C109100 | Non-insulin-dependent diabetes mellitus with ophthalm comps | res21: DMII | diagnostic | Read |
C109111 | Type II diabetes mellitus with ophthalmic complications | res21: DMII | diagnostic | Read |
C109112 | Type 2 diabetes mellitus with ophthalmic complications | res21: DMII | diagnostic | Read |
C109200 | Non-insulin-dependent diabetes mellitus with neuro comps | res21: DMII | diagnostic | Read |
C109211 | Type II diabetes mellitus with neurological complications | res21: DMII | diagnostic | Read |
C109212 | Type 2 diabetes mellitus with neurological complications | res21: DMII | diagnostic | Read |
C109300 | Non-insulin-dependent diabetes mellitus with multiple comps | res21: DMII | diagnostic | Read |
C109400 | Non-insulin dependent diabetes mellitus with ulcer | res21: DMII | diagnostic | Read |
C109411 | Type II diabetes mellitus with ulcer | res21: DMII | diagnostic | Read |
C109412 | Type 2 diabetes mellitus with ulcer | res21: DMII | diagnostic | Read |
C109500 | Non-insulin dependent diabetes mellitus with gangrene | res21: DMII | diagnostic | Read |
C109511 | Type II diabetes mellitus with gangrene | res21: DMII | diagnostic | Read |
C109512 | Type 2 diabetes mellitus with gangrene | res21: DMII | diagnostic | Read |
C109600 | Non-insulin-dependent diabetes mellitus with retinopathy | res21: DMII | diagnostic | Read |
C109611 | Type II diabetes mellitus with retinopathy | res21: DMII | diagnostic | Read |
C109612 | Type 2 diabetes mellitus with retinopathy | res21: DMII | diagnostic | Read |
C109700 | Non-insulin dependent diabetes mellitus - poor control | res21: DMII | diagnostic | Read |
C109711 | Type II diabetes mellitus - poor control | res21: DMII | diagnostic | Read |
C109712 | Type 2 diabetes mellitus - poor control | res21: DMII | diagnostic | Read |
C109900 | Non-insulin-dependent diabetes mellitus without complication | res21: DMII | diagnostic | Read |
C109A00 | Non-insulin dependent diabetes mellitus with mononeuropathy | res21: DMII | diagnostic | Read |
C109A11 | Type II diabetes mellitus with mononeuropathy | res21: DMII | diagnostic | Read |
C109B00 | Non-insulin dependent diabetes mellitus with polyneuropathy | res21: DMII | diagnostic | Read |
C109B11 | Type II diabetes mellitus with polyneuropathy | res21: DMII | diagnostic | Read |
C109C00 | Non-insulin dependent diabetes mellitus with nephropathy | res21: DMII | diagnostic | Read |
C109C11 | Type II diabetes mellitus with nephropathy | res21: DMII | diagnostic | Read |
C109C12 | Type 2 diabetes mellitus with nephropathy | res21: DMII | diagnostic | Read |
C109D00 | Non-insulin dependent diabetes mellitus with hypoglyca coma | res21: DMII | diagnostic | Read |
C109D11 | Type II diabetes mellitus with hypoglycaemic coma | res21: DMII | diagnostic | Read |
C109D12 | Type 2 diabetes mellitus with hypoglycaemic coma | res21: DMII | diagnostic | Read |
C109E00 | Non-insulin depend diabetes mellitus with diabetic cataract | res21: DMII | diagnostic | Read |
C109E11 | Type II diabetes mellitus with diabetic cataract | res21: DMII | diagnostic | Read |
C109E12 | Type 2 diabetes mellitus with diabetic cataract | res21: DMII | diagnostic | Read |
C109F11 | Type II diabetes mellitus with peripheral angiopathy | res21: DMII | diagnostic | Read |
C109F12 | Type 2 diabetes mellitus with peripheral angiopathy | res21: DMII | diagnostic | Read |
C109G00 | Non-insulin dependent diabetes mellitus with arthropathy | res21: DMII | diagnostic | Read |
C109G11 | Type II diabetes mellitus with arthropathy | res21: DMII | diagnostic | Read |
C109G12 | Type 2 diabetes mellitus with arthropathy | res21: DMII | diagnostic | Read |
C109H11 | Type II diabetes mellitus with neuropathic arthropathy | res21: DMII | diagnostic | Read |
C109H12 | Type 2 diabetes mellitus with neuropathic arthropathy | res21: DMII | diagnostic | Read |
C109J00 | Insulin treated Type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C109J11 | Insulin treated non-insulin dependent diabetes mellitus | res21: DMII | diagnostic | Read |
C109J12 | Insulin treated Type II diabetes mellitus | res21: DMII | diagnostic | Read |
C109K00 | Hyperosmolar non-ketotic state in type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C10D.00 | Diabetes mellitus autosomal dominant type 2 | res21: DMII | diagnostic | Read |
C10F.00 | Type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C10F.11 | Type II diabetes mellitus | res21: DMII | diagnostic | Read |
C10F000 | Type 2 diabetes mellitus with renal complications | res21: DMII | diagnostic | Read |
C10F011 | Type II diabetes mellitus with renal complications | res21: DMII | diagnostic | Read |
C10F100 | Type 2 diabetes mellitus with ophthalmic complications | res21: DMII | diagnostic | Read |
C10F111 | Type II diabetes mellitus with ophthalmic complications | res21: DMII | diagnostic | Read |
C10F200 | Type 2 diabetes mellitus with neurological complications | res21: DMII | diagnostic | Read |
C10F211 | Type II diabetes mellitus with neurological complications | res21: DMII | diagnostic | Read |
C10F300 | Type 2 diabetes mellitus with multiple complications | res21: DMII | diagnostic | Read |
C10F311 | Type II diabetes mellitus with multiple complications | res21: DMII | diagnostic | Read |
C10F400 | Type 2 diabetes mellitus with ulcer | res21: DMII | diagnostic | Read |
C10F411 | Type II diabetes mellitus with ulcer | res21: DMII | diagnostic | Read |
C10F500 | Type 2 diabetes mellitus with gangrene | res21: DMII | diagnostic | Read |
C10F511 | Type II diabetes mellitus with gangrene | res21: DMII | diagnostic | Read |
C10F600 | Type 2 diabetes mellitus with retinopathy | res21: DMII | diagnostic | Read |
C10F611 | Type II diabetes mellitus with retinopathy | res21: DMII | diagnostic | Read |
C10F700 | Type 2 diabetes mellitus - poor control | res21: DMII | diagnostic | Read |
C10F711 | Type II diabetes mellitus - poor control | res21: DMII | diagnostic | Read |
C10F900 | Type 2 diabetes mellitus without complication | res21: DMII | diagnostic | Read |
C10F911 | Type II diabetes mellitus without complication | res21: DMII | diagnostic | Read |
C10FA00 | Type 2 diabetes mellitus with mononeuropathy | res21: DMII | diagnostic | Read |
C10FA11 | Type II diabetes mellitus with mononeuropathy | res21: DMII | diagnostic | Read |
C10FB00 | Type 2 diabetes mellitus with polyneuropathy | res21: DMII | diagnostic | Read |
C10FB11 | Type II diabetes mellitus with polyneuropathy | res21: DMII | diagnostic | Read |
C10FC00 | Type 2 diabetes mellitus with nephropathy | res21: DMII | diagnostic | Read |
C10FC11 | Type II diabetes mellitus with nephropathy | res21: DMII | diagnostic | Read |
C10FD00 | Type 2 diabetes mellitus with hypoglycaemic coma | res21: DMII | diagnostic | Read |
C10FD11 | Type II diabetes mellitus with hypoglycaemic coma | res21: DMII | diagnostic | Read |
C10FE00 | Type 2 diabetes mellitus with diabetic cataract | res21: DMII | diagnostic | Read |
C10FE11 | Type II diabetes mellitus with diabetic cataract | res21: DMII | diagnostic | Read |
C10FF00 | Type 2 diabetes mellitus with peripheral angiopathy | res21: DMII | diagnostic | Read |
C10FG00 | Type 2 diabetes mellitus with arthropathy | res21: DMII | diagnostic | Read |
C10FG11 | Type II diabetes mellitus with arthropathy | res21: DMII | diagnostic | Read |
C10FH00 | Type 2 diabetes mellitus with neuropathic arthropathy | res21: DMII | diagnostic | Read |
C10FJ00 | Insulin treated Type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C10FJ11 | Insulin treated Type II diabetes mellitus | res21: DMII | diagnostic | Read |
C10FK00 | Hyperosmolar non-ketotic state in type 2 diabetes mellitus | res21: DMII | diagnostic | Read |
C10FL00 | Type 2 diabetes mellitus with persistent proteinuria | res21: DMII | diagnostic | Read |
C10FL11 | Type II diabetes mellitus with persistent proteinuria | res21: DMII | diagnostic | Read |
C10FM00 | Type 2 diabetes mellitus with persistent microalbuminuria | res21: DMII | diagnostic | Read |
C10FM11 | Type II diabetes mellitus with persistent microalbuminuria | res21: DMII | diagnostic | Read |
C10FN00 | Type 2 diabetes mellitus with ketoacidosis | res21: DMII | diagnostic | Read |
C10FP00 | Type 2 diabetes mellitus with ketoacidotic coma | res21: DMII | diagnostic | Read |
C10FQ00 | Type 2 diabetes mellitus with exudative maculopathy | res21: DMII | diagnostic | Read |
C10FR00 | Type 2 diabetes mellitus with gastroparesis | res21: DMII | diagnostic | Read |
ZC2CA00 | Dietary advice for type II diabetes | res21: DMII | diagnostic | Read |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH522/version/1044/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH522/version/1044/detail/?format=json |
R Package |
|
To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH522/version/1044/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH522/version/1044/export/codes/?format=json |
CSV | site_root/phenotypes/PH522/version/1044/export/codes/ |
R Package |
|
Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
1044 | Diabetes Mellitus Type II (DMII) | ieuan.scanlon | 2021-10-06 | currently shown |
Export - export all codes into a csv file/JSON/XML for the current phenotype version.
Print - Print page.