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 | Coding System (OXMIS Read) | Category |
---|---|---|---|---|
G2...00 | Hypertensive disease | res21: HT | Read | diagnostic |
G2...11 | BP - hypertensive disease | res21: HT | Read | diagnostic |
G20..00 | Essential hypertension | res21: HT | Read | diagnostic |
G200.00 | Malignant essential hypertension | res21: HT | Read | diagnostic |
G201.00 | Benign essential hypertension | res21: HT | Read | diagnostic |
G202.00 | Systolic hypertension | res21: HT | Read | diagnostic |
G20z.00 | Essential hypertension NOS | res21: HT | Read | diagnostic |
G20z.11 | Hypertension NOS | res21: HT | Read | diagnostic |
G21..00 | Hypertensive heart disease | res21: HT | Read | diagnostic |
G210.00 | Malignant hypertensive heart disease | res21: HT | Read | diagnostic |
G210000 | Malignant hypertensive heart disease without CCF | res21: HT | Read | diagnostic |
G210100 | Malignant hypertensive heart disease with CCF | res21: HT | Read | diagnostic |
G210z00 | Malignant hypertensive heart disease NOS | res21: HT | Read | diagnostic |
G211.00 | Benign hypertensive heart disease | res21: HT | Read | diagnostic |
G211000 | Benign hypertensive heart disease without CCF | res21: HT | Read | diagnostic |
G211100 | Benign hypertensive heart disease with CCF | res21: HT | Read | diagnostic |
G21z.00 | Hypertensive heart disease NOS | res21: HT | Read | diagnostic |
G21z000 | Hypertensive heart disease NOS without CCF | res21: HT | Read | diagnostic |
G21z011 | Cardiomegaly - hypertensive | res21: HT | Read | diagnostic |
G21z100 | Hypertensive heart disease NOS with CCF | res21: HT | Read | diagnostic |
G21zz00 | Hypertensive heart disease NOS | res21: HT | Read | diagnostic |
G22..00 | Hypertensive renal disease | res21: HT | Read | diagnostic |
G220.00 | Malignant hypertensive renal disease | res21: HT | Read | diagnostic |
G221.00 | Benign hypertensive renal disease | res21: HT | Read | diagnostic |
G222.00 | Hypertensive renal disease with renal failure | res21: HT | Read | diagnostic |
G22z.00 | Hypertensive renal disease NOS | res21: HT | Read | diagnostic |
G22z.11 | Renal hypertension | res21: HT | Read | diagnostic |
G23..00 | Hypertensive heart and renal disease | res21: HT | Read | diagnostic |
G230.00 | Malignant hypertensive heart and renal disease | res21: HT | Read | diagnostic |
G231.00 | Benign hypertensive heart and renal disease | res21: HT | Read | diagnostic |
G232.00 | Hypertensive heart&renal dis wth (congestive) heart failure | res21: HT | Read | diagnostic |
G233.00 | Hypertensive heart and renal disease with renal failure | res21: HT | Read | diagnostic |
G234.00 | Hyperten heart&renal dis+both(congestv)heart and renal fail | res21: HT | Read | diagnostic |
G23z.00 | Hypertensive heart and renal disease NOS | res21: HT | Read | diagnostic |
G24..00 | Secondary hypertension | res21: HT | Read | diagnostic |
G240.00 | Secondary malignant hypertension | res21: HT | Read | diagnostic |
G240000 | Secondary malignant renovascular hypertension | res21: HT | Read | diagnostic |
G240z00 | Secondary malignant hypertension NOS | res21: HT | Read | diagnostic |
G241.00 | Secondary benign hypertension | res21: HT | Read | diagnostic |
G241000 | Secondary benign renovascular hypertension | res21: HT | Read | diagnostic |
G241z00 | Secondary benign hypertension NOS | res21: HT | Read | diagnostic |
G244.00 | Hypertension secondary to endocrine disorders | res21: HT | Read | diagnostic |
G24z.00 | Secondary hypertension NOS | res21: HT | Read | diagnostic |
G24z000 | Secondary renovascular hypertension NOS | res21: HT | Read | diagnostic |
G24zz00 | Secondary hypertension NOS | res21: HT | Read | diagnostic |
G2y..00 | Other specified hypertensive disease | res21: HT | Read | diagnostic |
G2z..00 | Hypertensive disease NOS | res21: HT | Read | diagnostic |
Gyu2000 | [X]Other secondary hypertension | res21: HT | Read | diagnostic |
Gyu2100 | [X]Hypertension secondary to other renal disorders | res21: HT | Read | diagnostic |
L120.00 | Benign essential hypertension in pregnancy/childbirth/puerp | res21: HT | Read | diagnostic |
L120000 | Benign essential hypertension in preg/childb/puerp unspec | res21: HT | Read | diagnostic |
L120100 | Benign essential hypertension in preg/childb/puerp - deliv | res21: HT | Read | diagnostic |
L120300 | Benign essential hypertension in preg/childb/puerp-not deliv | res21: HT | Read | diagnostic |
L120400 | Benign essential hypertension in preg/childb/puerp +p/n comp | res21: HT | Read | diagnostic |
L120z00 | Benign essential hypertension in preg/childb/puerp NOS | res21: HT | Read | diagnostic |
L121.00 | Renal hypertension in pregnancy/childbirth/puerperium | res21: HT | Read | diagnostic |
L121000 | Renal hypertension in pregnancy/childbirth/puerp unspecified | res21: HT | Read | diagnostic |
L121100 | Renal hypertension in pregnancy/childbirth/puerp - delivered | res21: HT | Read | diagnostic |
L121300 | Renal hypertension in preg/childbirth/puerp - not delivered | res21: HT | Read | diagnostic |
L121z00 | Renal hypertension in pregnancy/childbirth/puerperium NOS | res21: HT | Read | diagnostic |
L122.00 | Other pre-existing hypertension in preg/childbirth/puerp | res21: HT | Read | diagnostic |
L122000 | Other pre-existing hypertension in preg/childb/puerp unspec | res21: HT | Read | diagnostic |
L122100 | Other pre-existing hypertension in preg/childb/puerp - deliv | res21: HT | Read | diagnostic |
L122300 | Other pre-exist hypertension in preg/childb/puerp-not deliv | res21: HT | Read | diagnostic |
L122z00 | Other pre-existing hypertension in preg/childb/puerp NOS | res21: HT | Read | diagnostic |
L128.00 | Pre-exist hypertension compl preg childbirth and puerperium | res21: HT | Read | diagnostic |
L128200 | Pre-exist 2ndry hypertens comp preg childbth and puerperium | res21: HT | Read | diagnostic |
Code | Description | Entity type | Coding System (OXMIS Read) | Category |
---|---|---|---|---|
3053HT | NEUROGENIC HYPERTENSION (SECONDARY) | res21: HT | OXMIS | diagnostic |
4000 | MALIGNANT HYPERTENSION | res21: HT | OXMIS | diagnostic |
4003 | HYPERTENSIVE NEPHROPATHY | res21: HT | OXMIS | diagnostic |
4003AA | HYPERTENSIVE RENAL DISEASE | res21: HT | OXMIS | diagnostic |
401 | BENIGN HYPERTENSION | res21: HT | OXMIS | diagnostic |
401 A | HYPERTENSION | res21: HT | OXMIS | diagnostic |
401 AC | HYPERTENSION ACCELERATED | res21: HT | OXMIS | diagnostic |
401 AR | HYPERTENSION ARTERIOSCLEROTIC | res21: HT | OXMIS | diagnostic |
401 AT | HYPERTENSION ATHEROSCLEROTIC | res21: HT | OXMIS | diagnostic |
401 BM | HYPERTENSION ON TREATMENT | res21: HT | OXMIS | diagnostic |
401 BN | HYPERTENSION BENIGN | res21: HT | OXMIS | diagnostic |
401 C | HYPERTENSION ESSENTIAL | res21: HT | OXMIS | diagnostic |
401 DC | HYPERTENSION DIASTOLIC | res21: HT | OXMIS | diagnostic |
401 E | HYPERTENSION ARTERIAL | res21: HT | OXMIS | diagnostic |
401 EL | HYPERTENSION ARTERIAL SYSTEMIC | res21: HT | OXMIS | diagnostic |
401 LB | HYPERTENSION LABILE INTERMITTENT | res21: HT | OXMIS | diagnostic |
401 P | HYPERTENSION ARTERIAL PRIMARY | res21: HT | OXMIS | diagnostic |
401 PA | HYPERTENSION PRIMARY | res21: HT | OXMIS | diagnostic |
401 S | HYPERTENSION SYSTOLIC | res21: HT | OXMIS | diagnostic |
402 | HYPERTENSIVE HEART DISEASE | res21: HT | OXMIS | diagnostic |
402 C | HYPERTENSION CONGESTIVE HEART FAILURE | res21: HT | OXMIS | diagnostic |
402 MF | MYOCARDIAL FIBROSIS WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
402 VH | VENTRICULAR HYPERTROPHY HYPERTENSIVE | res21: HT | OXMIS | diagnostic |
403 | RENAL HYPERTENSION | res21: HT | OXMIS | diagnostic |
403 AA | RENAL HYPERTENSIVE DISEASE | res21: HT | OXMIS | diagnostic |
403 AH | RENOVASCULAR HYPERTENSION | res21: HT | OXMIS | diagnostic |
403 NC | HYPERTENSION IMPAIRED RENAL FUNCTION | res21: HT | OXMIS | diagnostic |
403 NF | HYPERTENSION RENAL INSUFFICIENCY | res21: HT | OXMIS | diagnostic |
403 NG | HYPERTENSIVE GLOMERULOSCLEROSIS | res21: HT | OXMIS | diagnostic |
4100N | MYOCARDIAL INFARCT WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4100NA | MYOCARDIAL INFARCT ACUTE WITH HYPERTENSI | res21: HT | OXMIS | diagnostic |
4100T | THROMBOSIS CORONARY WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4120 | INSUFFICIENCY CORONARY HYPERTENSIVE | res21: HT | OXMIS | diagnostic |
4120A | ISCHAEMIC HEART DISEASE HYPERTENSIVE | res21: HT | OXMIS | diagnostic |
4120BD | SYNDROME DRESSLER'S WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4120CA | CORONARY ARTERY DISEASE WITH HYPERTENSIO | res21: HT | OXMIS | diagnostic |
4120M | MYOCARDIAL ISCHAEMIA WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4130 | ANGINA PECTORIS WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4130E | ANGINA EFFORT WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4140 | ASYMPTOMATIC HYPERTENSIVE ISCHAEMIC HEAR | res21: HT | OXMIS | diagnostic |
4300 | SUBARACHNOID HAEMORRHAGE WITH HYPERTENSI | res21: HT | OXMIS | diagnostic |
4310 | HAEMORRHAGE INTRACEREBRAL WITH HYPERTENS | res21: HT | OXMIS | diagnostic |
4330 | CEREBRAL THROMBOSIS WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4340 | EMBOLISM CEREBRAL WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4340CR | EMBOLISM INTRACRANIAL WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4360A | CEREBROVASCULAR ACCIDENT WITH HYPERTENSI | res21: HT | OXMIS | diagnostic |
4360B | STROKE WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4360D | HYPERTENSIVE ENCEPHALOPATHY | res21: HT | OXMIS | diagnostic |
4370 | CEREBRAL ISCHAEMIA HYPERTENSIVE | res21: HT | OXMIS | diagnostic |
4380 | CEREBROVASCULAR DISEASE WITH HYPERTENSIO | res21: HT | OXMIS | diagnostic |
4380HP | HEMIPLEGIA WITH HYPERTENSION | res21: HT | OXMIS | diagnostic |
4419H | HYPERTENSION ANEURYSM AORTA | res21: HT | OXMIS | diagnostic |
To Export Phenotype Details:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH533/version/1066/detail/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH533/version/1066/detail/?format=json |
R Package |
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To Export Phenotype Code List:
Format | API |
---|---|
XML | site_root/api/v1/public/phenotypes/PH533/version/1066/export/codes/?format=xml |
JSON | site_root/api/v1/public/phenotypes/PH533/version/1066/export/codes/?format=json |
CSV | site_root/phenotypes/PH533/version/1066/export/codes/ |
R Package |
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Version ID |
Name | Owner | Publish date | |
---|---|---|---|---|
1066 | Hypertension | ieuan.scanlon | 2021-10-06 | currently shown |
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