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Contrceptive

S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Aschroft

Type
Drug
ID
PH658
Version ID
1316
Data Sources
Valid event data range
Start - 01/02/2013
Sex
Female, Male
Agreement Date
2015-11-03
Coding system
GPRD product codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Study question:

What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices?

Methods:

A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin.

Study answer and limitations:

49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators. Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in patients receiving warfarin.

What this study adds:

The high prevalence for certain indicators emphasises existing prescribing risks and the need for their appropriate consideration within primary care, particularly for older patients and those taking multiple medications. The high variation between practices indicates potential for improvement through targeted practice level intervention.

Publications

  • S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft, Examining variations in prescribing safety in UK general practice cross sectional study using the Clinical Practice Research Datalink. BMJ, 351(h5501), 2015.

Clinical Code List

Rows: 115
Code Description Coding System (CPRD_product_code) Entity type Category
1062 Ovranette 150microgram/30microgram tablets (Pfizer Ltd) CPRD_product_code res25: contraceptives drug
1071 Cilest 250microgram/35microgram tablets (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
11910 Ethinylestradiol 20microgram / Gestodene 75microgram tablets CPRD_product_code res25: contraceptives drug
125 Dianette tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
12631 Ethinylestradiol with levonorgestrel and placebo 30micrograms + 150micrograms Tablet CPRD_product_code res25: contraceptives drug
13248 Ethinylestradiol 30microgram / Desogestrel 150microgram tablets CPRD_product_code res25: contraceptives drug
1352 Loestrin 30 tablets (Galen Ltd) CPRD_product_code res25: contraceptives drug
1354 Brevinor 500microgram/35microgram tablets (Pfizer Ltd) CPRD_product_code res25: contraceptives drug
1378 Mercilon 150microgram/20microgram tablets (Merck Sharp & Dohme Ltd) CPRD_product_code res25: contraceptives drug
13810 Ethinylestradiol with levonorgestrel for post-coital contraception 50micrograms + 250micrograms Tabl CPRD_product_code res25: contraceptives drug
1427 Loestrin 20 tablets (Galen Ltd) CPRD_product_code res25: contraceptives drug
14459 Gynovlar 21 Tablet (Schering Health Care Ltd) CPRD_product_code res25: contraceptives drug
14601 Ethinylestradiol 35microgram / Norgestimate 250microgram tablets CPRD_product_code res25: contraceptives drug
14670 Ethinylestradiol with norethisterone - biphasic 7 x 35mcg+500mcg; 14 x 35mcg+1mg Tablet CPRD_product_code res25: contraceptives drug
14977 Ethinylestradiol with gestodene - triphasic 6 x 30+50mcg; 5 x 40+70mcg; 10 x 30+100mcg Tablet CPRD_product_code res25: contraceptives drug
15886 Ethinylestradiol with levonorgestrel - triphasic 6x30+50mcg; 5x40+75mcg; 10x30+125mcg Tablet CPRD_product_code res25: contraceptives drug
15987 Ethinylestradiol with norethisterone - triphasic 7 x 35+500mcg; 7 x 35+750mcg; 7 x 35mcg+1mg Tablet CPRD_product_code res25: contraceptives drug
1601 Trinovum tablets (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
16110 Ethinylestradiol 20microgram / Desogestrel 150microgram tablets CPRD_product_code res25: contraceptives drug
1752 Eugynon 30 tablets (Schering Health Care Ltd) CPRD_product_code res25: contraceptives drug
17756 Mestranol 50microgram / Norethisterone 1mg tablets CPRD_product_code res25: contraceptives drug
18569 Gestodene with ethinylestradiol 75microgramwith20microgram Tablet CPRD_product_code res25: contraceptives drug
18823 Ethinylestradiol 30microgram / Norethisterone acetate 1.5mg tablets CPRD_product_code res25: contraceptives drug
19131 Ethinylestradiol with gestodene and placebo 30micrograms + 75micrograms Tablet CPRD_product_code res25: contraceptives drug
19551 Controvlar Tablet (Schering Health Care Ltd) CPRD_product_code res25: contraceptives drug
1988 Binovum tablets (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
2026 Logynon ED tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
2084 Ovran 30 Tablet (Wyeth Pharmaceuticals) CPRD_product_code res25: contraceptives drug
21343 Minovlar ed Tablet (Schering Health Care Ltd) CPRD_product_code res25: contraceptives drug
21733 Gestodene with ethinylestradiol 75microgramwith30microgram Tablet CPRD_product_code res25: contraceptives drug
22603 Clairette 2000/35 tablets (Stragen UK Ltd) CPRD_product_code res25: contraceptives drug
23211 Desogestrel with ethinylestradiol 150micrograms with 30micrograms tablets CPRD_product_code res25: contraceptives drug
23218 Ethinylestradiol with cyproterone acetate 35microgram with 2mg tablets CPRD_product_code res25: contraceptives drug
2354 Ovysmen 500microgram/35microgram tablets (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
23897 Ethinylestradiol with levonorgestrel - triphasic with placebo 6x30+50mcg; 5x40+75mcg; 10x30+125mcg T CPRD_product_code res25: contraceptives drug
25124 Acnocin 2000microgram/35microgram tablets (Sandoz Ltd) CPRD_product_code res25: contraceptives drug
25263 Norgestimate with ethinylestradiol 250micrograms + 35micrograms Tablet CPRD_product_code res25: contraceptives drug
2769 Cyproterone acetate with ethinylestradiol 2mg with 35micrograms tablets CPRD_product_code res25: contraceptives drug
2856 Norimin 1mg/35microgram tablets (Pfizer Ltd) CPRD_product_code res25: contraceptives drug
29499 Ethinylestradiol 33.9micrograms/24hours / Norelgestromin 203micrograms/24hours transdermal patches CPRD_product_code res25: contraceptives drug
31528 Ethinylestradiol with norethisterone - triphasic 7x35+500mcg; 9x35mcg+1mg; 5x35+500mcg Tablet CPRD_product_code res25: contraceptives drug
31902 Cicafem 2000/35 tablets (Galen Ltd) CPRD_product_code res25: contraceptives drug
33098 Diva 2000/35 tablets (Zeroderma Ltd) CPRD_product_code res25: contraceptives drug
3436 Ortho-novin 1/50 Tablet (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
3471 Femodene ED tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
3472 Trinovum ed ED tablets (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
3538 Neocon 1/35 Tablet (Cilag Pharmaceuticals Ltd) CPRD_product_code res25: contraceptives drug
36829 Katya 30/75 tablets (Stragen UK Ltd) CPRD_product_code res25: contraceptives drug
3693 Triadene tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
37073 Sunya 20/75 tablets (Stragen UK Ltd) CPRD_product_code res25: contraceptives drug
38500 Co-cyprindiol 2000microgram/35microgram tablets (Fannin UK Ltd) CPRD_product_code res25: contraceptives drug
39517 NuvaRing 0.12mg/0.015mg per day vaginal delivery system (Merck Sharp & Dohme Ltd) CPRD_product_code res25: contraceptives drug
40305 Qlaira tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
4039 Tri-Minulet tablets (Wyeth Pharmaceuticals) CPRD_product_code res25: contraceptives drug
40512 Ethinylestradiol 2.7mg / Etonogestrel 11.7mg vaginal delivery system CPRD_product_code res25: contraceptives drug
40618 Estradiol valerate and (estradiol valerate with dienogest) tablets CPRD_product_code res25: contraceptives drug
40650 Ethinylestradiol with norethisterone 35micrograms + 750micrograms Tablet CPRD_product_code res25: contraceptives drug
41 Microgynon 30 tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
42510 Ethinylestradiol with levonorgestrel Tablet CPRD_product_code res25: contraceptives drug
43003 Levest 150/30 tablets (Morningside Healthcare Ltd) CPRD_product_code res25: contraceptives drug
43009 Minovlar 21 Tablet (Schering Health Care Ltd) CPRD_product_code res25: contraceptives drug
44046 Rigevidon tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
441 Ovran tablets (Wyeth Pharmaceuticals) CPRD_product_code res25: contraceptives drug
44229 Millinette 20microgram/75microgram tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
44278 TriRegol tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
443 Desogestrel with ethinylestradiol 150micrograms with 20micrograms tablets CPRD_product_code res25: contraceptives drug
44336 Gedarel 30microgram/150microgram tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
44457 Gedarel 20microgram/150microgram tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
44994 Millinette 30microgram/75microgram tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
45059 Ethinylestradiol with levonorgestrel 30micrograms + 50micrograms Tablet CPRD_product_code res25: contraceptives drug
45557 Levest 150/30 tablets (Actavis UK Ltd) CPRD_product_code res25: contraceptives drug
4608 Dianette tablets (Generics (UK) Ltd) CPRD_product_code res25: contraceptives drug
47057 Yasminelle 3mg+20microgram Tablet (Bayer Plc) CPRD_product_code res25: contraceptives drug
47132 Co-cyprindiol 2mg+35microgram Tablet (Sandoz Ltd) CPRD_product_code res25: contraceptives drug
47281 Elevin 150microgram/30microgram tablets (MedRx Healthcare LLP) CPRD_product_code res25: contraceptives drug
4917 Microgynon 30 ED tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
49214 Cilest 250microgram/35microgram tablets (Mawdsley-Brooks & Company Ltd) CPRD_product_code res25: contraceptives drug
4964 Femodette tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
49700 Marvelon tablets (DE Pharmaceuticals) CPRD_product_code res25: contraceptives drug
51482 Generic Microgynon 30 ED tablets CPRD_product_code res25: contraceptives drug
52443 Microgynon 30 tablets (Mawdsley-Brooks & Company Ltd) CPRD_product_code res25: contraceptives drug
52818 Yasmin tablets (Mawdsley-Brooks & Company Ltd) CPRD_product_code res25: contraceptives drug
53201 Dianette tablets (Lexon (UK) Ltd) CPRD_product_code res25: contraceptives drug
5576 Synphase tablets (Pfizer Ltd) CPRD_product_code res25: contraceptives drug
56311 Yaz tablets (Imported (United States)) CPRD_product_code res25: contraceptives drug
56483 Generic Tri-Minulet tablets CPRD_product_code res25: contraceptives drug
56539 Zoely 2.5mg/1.5mg tablets (Merck Sharp & Dohme Ltd) CPRD_product_code res25: contraceptives drug
56553 Generic Trinovum tablets CPRD_product_code res25: contraceptives drug
56868 Generic Logynon ED tablets CPRD_product_code res25: contraceptives drug
57181 Lizinna 250microgram/35microgram tablets (Morningside Healthcare Ltd) CPRD_product_code res25: contraceptives drug
57264 Estradiol 1.5mg / Nomegestrol 2.5mg tablets CPRD_product_code res25: contraceptives drug
5862 Norinyl-1 tablets (Pfizer Ltd) CPRD_product_code res25: contraceptives drug
58642 Cimizt 30microgram/150microgram tablets (Morningside Healthcare Ltd) CPRD_product_code res25: contraceptives drug
59149 Generic Qlaira tablets CPRD_product_code res25: contraceptives drug
59383 Lestramyl 30microgram/150microgram tablets (Generics (UK) Ltd) CPRD_product_code res25: contraceptives drug
59503 Lucette 0.03mg/3mg tablets (Consilient Health Ltd) CPRD_product_code res25: contraceptives drug
6166 Evra transdermal patches (Janssen-Cilag Ltd) CPRD_product_code res25: contraceptives drug
6431 Co-cyprindiol 2000microgram/35microgram tablets CPRD_product_code res25: contraceptives drug
6596 Norelgestromin with ethinylestradiol 203micrograms + 33.9micrograms/24hours Transdermal patch CPRD_product_code res25: contraceptives drug
6686 Ethinylestradiol 30microgram / Levonorgestrel 150microgram tablets CPRD_product_code res25: contraceptives drug
6716 Ethinylestradiol 30microgram / Drospirenone 3mg tablets CPRD_product_code res25: contraceptives drug
697 Yasmin tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
7699 Levonorgestrel 250microgram / Ethinylestradiol 30microgram tablets CPRD_product_code res25: contraceptives drug
7776 Ethinylestradiol 30microgram / Gestodene 75microgram tablets CPRD_product_code res25: contraceptives drug
7814 Ethinylestradiol 35microgram / Norethisterone 500microgram tablets CPRD_product_code res25: contraceptives drug
8103 Conova 30 Tablet (Pharmacia Ltd) CPRD_product_code res25: contraceptives drug
8176 Ethinylestradiol 20microgram / Norethisterone acetate 1mg tablets CPRD_product_code res25: contraceptives drug
8482 Ethinylestradiol 35microgram / Norethisterone 1mg tablets CPRD_product_code res25: contraceptives drug
8718 Levonorgestrel 250microgram / Ethinylestradiol 50microgram tablets CPRD_product_code res25: contraceptives drug
9119 Minilyn Tablet (Organon Laboratories Ltd) CPRD_product_code res25: contraceptives drug
935 Marvelon tablets (Merck Sharp & Dohme Ltd) CPRD_product_code res25: contraceptives drug
936 Femodene tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug
937 Trinordiol tablets (Wyeth Pharmaceuticals) CPRD_product_code res25: contraceptives drug
977 Minulet tablets (Wyeth Pharmaceuticals) CPRD_product_code res25: contraceptives drug
978 Logynon tablets (Bayer Plc) CPRD_product_code res25: contraceptives drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH658/version/1316/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH658/version/1316/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('PH658', '1316', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH658/version/1316/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH658/version/1316/export/codes/?format=json
CSV site_root/phenotypes/PH658/version/1316/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('PH658', '1316', api_client=client)

Version History

Version
ID
Name Owner Publish date
1316 Contrceptive 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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