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Metformin

Evangelos Kontopantelis, David A Springate, David Reeves, Darren M. Aschroff, Martin Rutter, Iain Buchan, Tim Doran, Matthias Pierce, Darren M. Ashcroft

Type
Drug
ID
PH546
Version ID
1092
Data Sources
Valid event data range
01/04/2006 - 31/03/2012
Sex
Female, Male
Agreement Date
2014-12-16
Coding system
GPRD product codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Data source:

We used the Clinical Practice Research Datalink (CPRD), a large primary care database that holds complete electronic patient records (including diagnoses, prescriptions and referrals) from participating family practices across the UK. A hierarchical clinical coding system (Read) is used to record the data. In July 2012, data were available for 644 practices and 13,772,992 patients. Full details of the database have been provided elsewhere.

Diabetes cohort:

We extracted data from 1 April 2006 to 31 March 2012 and, for ease of reporting and analysing, aggregated information into six financial years. Within each year, practice inclusion eligibility was determined by a CPRD assessment algorithm, which informs on practices considered to be of research standard; therefore, our cohort of practices varied over time. For each research standard practice and year, we defined as eligible patients those who were registered with the practice for the full year and were aged 18 years or over in that year. From these patients, using relevant Read codes for type 2 diabetes (e.g. C10F.00: Type 2 diabetes mellitus) and excluding those treated with insulin within 2 years of diagnosis, we identified 246,544 patients over the study period. Diagnoses were not constrained to the study period and a relevant code prior to the study as well as during the study period would flag a patient from the respective year onwards. Data on sex, age and removal from the database due to deaths were available and complete for all patients.We extracted data on diabetes-related macrovascular (myocardial infarction, stroke, peripheral vascular disease or amputation) and microvascular (retinopathy, neuropathy, nephropathy [chronic kidney disease stages 4–5] or foot ulcer) complications as well as comorbidities (asthma, coronary heart disease, chronic kidney disease [excluded from microvascular analysis], chronic obstructive pulmonary disease, depression, dementia, severe mental illness, heart failure, hypertension, stroke [excluded from macrovascular analysis], cancer, epilepsy, osteoarthritis, osteoporosis and hypothyroidism). Although we aimed to include all conditions associated with diabetes, the choice was partially determined by the domains incentivised under the Quality and Outcomes Framework (QOF), for which accuracy of diagnosis is considered high. Information was also extracted on smoking (never smoked, current, exsmoker and missing data),BMI, HbA1c levels (%), cholesterol levels (mmol/l) and systolic/diastolic BP (mmHg). Biometric measurement data were cleaned and we calculated patient means for each year when more than one relevant record was available. Using product lists we determined prescription prevalence (at least one) for relevant medications: ACE inhibitors, acarbose, α-blockers, anticoagulants, antiplatelet agents, β-blockers, calcium-channel blockers, thiazide diuretics, loop diuretics, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide- 1 agonists, statins and other lipid-lowering drugs, meglitinides , metformin, sulfonylureas and thiazolidinediones. For approximately 60% of the practices, records were linked to Office of National Statistics (ONS) mortality data and we had access to death dates for all their patients. For these, using ICD-10 codes (www.who.int/classifications/icd/en/) we were able to estimate deathslinked to specific causes (underlying or in the top three): diabetes (E10–E16), ischaemic heart disease (I21–I22), stroke (I60–I64) or stroke excluding bleeds (excluding I63).

Publications

  • Evangelos Kontopantelis, David A Springate, David Reeves, Darren M. Aschroff, Martin Rutter, Iain Buchan, Tim Doran, Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study. Diabetologia, 58:505-518, 2015.

Clinical Code List

Rows: 43
Code Description Coding System (CPRD_product_code) Entity type Category
11990 metformin oral solution 500mg/5ml CPRD_product_code res9: metformin drug
16044 GLUCOPHAGE SR tablets 500mg [MERCK SER] CPRD_product_code res9: metformin drug
18220 pioglitazone with metformin tablets 15mg + 850mg CPRD_product_code res9: metformin drug
23 metformin tablets 500mg CPRD_product_code res9: metformin drug
25678 GLUCAMET tablets 500mg [OPUS] CPRD_product_code res9: metformin drug
26258 GLUCAMET tablets 850mg [OPUS] CPRD_product_code res9: metformin drug
27501 ORABET tablets 500mg [LAGAP] CPRD_product_code res9: metformin drug
30316 metformin with pioglitazone tablets 850mg + 15mg CPRD_product_code res9: metformin drug
31077 COMPETACT film coated tablets [TAKEDA] CPRD_product_code res9: metformin drug
31146 METSOL oral solution 500mg/5ml [ORBIS] CPRD_product_code res9: metformin drug
33087 METFORMIN tablets 500mg [ACTAVIS] CPRD_product_code res9: metformin drug
33674 METFORMIN tablets 850mg [HILLCROSS] CPRD_product_code res9: metformin drug
34004 METFORMIN tablets 500mg [IVAX] CPRD_product_code res9: metformin drug
34020 METFORMIN tablets 850mg [IVAX] CPRD_product_code res9: metformin drug
34135 METFORMIN tablets 500mg [M&A PHARM] CPRD_product_code res9: metformin drug
34323 METFORMIN tablets 500mg [HILLCROSS] CPRD_product_code res9: metformin drug
34504 METFORMIN tablets 500mg [WOCKHARDT] CPRD_product_code res9: metformin drug
34598 METFORMIN tablets 500mg [GEN (UK)] CPRD_product_code res9: metformin drug
34697 METFORMIN tablets 850mg [WOCKHARDT] CPRD_product_code res9: metformin drug
34742 METFORMIN tablets 850mg [TEVA] CPRD_product_code res9: metformin drug
34836 METFORMIN tablets 850mg [ACTAVIS] CPRD_product_code res9: metformin drug
34917 METFORMIN tablets 500mg [TEVA] CPRD_product_code res9: metformin drug
37874 vildagliptin with metformin tablets 50mg + 850mg CPRD_product_code res9: metformin drug
37902 vildagliptin with metformin tablets 50mg + 1000mg CPRD_product_code res9: metformin drug
38355 metformin modified release tablet 750mg CPRD_product_code res9: metformin drug
38400 GLUCOPHAGE SR tablets 750mg [MERCK SER] CPRD_product_code res9: metformin drug
38551 EUCREAS tablets 50mg + 1000mg [NOVARTIS] CPRD_product_code res9: metformin drug
39203 EUCREAS tablets 50mg + 850mg [NOVARTIS] CPRD_product_code res9: metformin drug
39560 BOLAMYN SR tablets 500mg [TEVA] CPRD_product_code res9: metformin drug
39598 metformin modified release tablet 1000mg CPRD_product_code res9: metformin drug
39729 GLUCOPHAGE SR tablets 1000mg [MERCK SER] CPRD_product_code res9: metformin drug
42161 ORABET tablets 500mg [SANDOZ] CPRD_product_code res9: metformin drug
43270 METFORMIN sugar free oral solution 500mg/5ml [ROSEMONT] CPRD_product_code res9: metformin drug
43619 sitagliptin with metformin tablets 50mg + 1000mg CPRD_product_code res9: metformin drug
43684 JANUMET tablets 50mg + 1000mg [M S D] CPRD_product_code res9: metformin drug
44250 METFORMIN oral solution 500mg/5ml [HILLCROSS] CPRD_product_code res9: metformin drug
45581 METABET SR tablets 500mg [MORNINGSID] CPRD_product_code res9: metformin drug
46989 METABET SR tablets 1000mg [MORNINGSID] CPRD_product_code res9: metformin drug
7048 metformin modified release tablet 500mg CPRD_product_code res9: metformin drug
7166 GLUCOPHAGE tablets 500mg [MERCK SER] CPRD_product_code res9: metformin drug
735 metformin oral suspension 100mg/ml CPRD_product_code res9: metformin drug
7610 GLUCOPHAGE tablets 850mg [MERCK SER] CPRD_product_code res9: metformin drug
93 metformin tablets 850mg CPRD_product_code res9: metformin drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH546/version/1092/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH546/version/1092/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH546', '1092', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH546/version/1092/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH546/version/1092/export/codes/?format=json
CSV site_root/phenotypes/PH546/version/1092/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH546', '1092', api_client=client)

Version History

Version
ID
Name Owner Publish date
1092 Metformin ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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