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Dementia (P13)

S Jill Stocks, Evangelos Kontopantelis, Roger T Webb, Anthony J Avery, Alistair Burns, Darren M Ashcroft

Type
Disease or Syndrome
ID
PH659
Version ID
1318
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2017-04-24
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Introduction:

Policy interventions to address inappropriate prescribing of antipsychotic drugs to older people diagnosed with dementia are commonplace. In the UK, warnings were issued by the Medicines Healthcare products Regulatory Agency in 2004, 2009 and 2012 and the National Institute for Health and Care Excellence guidance was published in 2006. It is important to evaluate the impact of such interventions.

Methods:

We analysed routinely collected primary-care data from 111,346 patients attending one of 689 general practices contributing to the Clinical Practice Research Datalink to describe the temporal changes in the prescribing of antipsychotic drugs to patients aged 65 years or over diagnosed with dementia without a concomitant psychosis diagnosis from 2001 to 2014 using an interrupted time series and a before-and-after design. Logistic regression methods were used to quantify the impact of patient and practice level variables on prescribing prevalence.

Results:

Prescribing of first-generation antipsychotic drugs reduced from 8.9% in 2001 to 1.4% in 2014 (prevalence ratio 2014/2001 adjusted for age, sex and clustering within practices (0.14, 95% confidence interval 0.12–0.16), whereas there was little change for second-generation antipsychotic drugs (1.01, confidence interval 0.94–1.17). Between 2004 and 2012, several policy interventions coincided with a pattern of ups and downs, whereas the 2006 National Institute for Health and Care Excellence guidance was followed by a gradual longer term reduction. Since 2013, the decreasing trend in second-generation antipsychotic drug prescribing has plateaued largely driven by the increasing prescribing of risperidone.

Conclusions:

Increased surveillance and evaluation of drug safety warnings and guidance are needed to improve the impact of future interventions.

Publications

  • S Jill Stocks, Evangelos Kontopantelis, Roger T Webb, Anthony J Avery, Alistair Burns, Darren M Ashcroft, Antipsychotic Prescribing to Patients Diagnosed with Dementia Without a Diagnosis of Psychosis in the Context of National Guidance and Drug Safety Warnings Longitudinal Study in UK General Practice. Drug Safety, 40(8), 679-692, 2017.

Clinical Code List

Rows: 96
Code Description Entity type Category Coding System (Read)
A411.00 Jakob-Creutzfeldt disease res53: P13_dementia diagnostic Read
E00..00 Senile and presenile organic psychotic conditions res53: P13_dementia diagnostic Read
E00..11 Senile dementia res53: P13_dementia diagnostic Read
E00..12 Senile/presenile dementia res53: P13_dementia diagnostic Read
E000.00 Uncomplicated senile dementia res53: P13_dementia diagnostic Read
E001.00 Presenile dementia res53: P13_dementia diagnostic Read
E001000 Uncomplicated presenile dementia res53: P13_dementia diagnostic Read
E001100 Presenile dementia with delirium res53: P13_dementia diagnostic Read
E001200 Presenile dementia with paranoia res53: P13_dementia diagnostic Read
E001300 Presenile dementia with depression res53: P13_dementia diagnostic Read
E001z00 Presenile dementia NOS res53: P13_dementia diagnostic Read
E002.00 Senile dementia with depressive or paranoid features res53: P13_dementia diagnostic Read
E002000 Senile dementia with paranoia res53: P13_dementia diagnostic Read
E002100 Senile dementia with depression res53: P13_dementia diagnostic Read
E002z00 Senile dementia with depressive or paranoid features NOS res53: P13_dementia diagnostic Read
E003.00 Senile dementia with delirium res53: P13_dementia diagnostic Read
E004.00 Arteriosclerotic dementia res53: P13_dementia diagnostic Read
E004.11 Multi infarct dementia res53: P13_dementia diagnostic Read
E004000 Uncomplicated arteriosclerotic dementia res53: P13_dementia diagnostic Read
E004100 Arteriosclerotic dementia with delirium res53: P13_dementia diagnostic Read
E004200 Arteriosclerotic dementia with paranoia res53: P13_dementia diagnostic Read
E004300 Arteriosclerotic dementia with depression res53: P13_dementia diagnostic Read
E004z00 Arteriosclerotic dementia NOS res53: P13_dementia diagnostic Read
E00y.00 Other senile and presenile organic psychoses res53: P13_dementia diagnostic Read
E00y.11 Presbyophrenic psychosis res53: P13_dementia diagnostic Read
E00z.00 Senile or presenile psychoses NOS res53: P13_dementia diagnostic Read
E012.00 Other alcoholic dementia res53: P13_dementia diagnostic Read
E012.11 Alcoholic dementia NOS res53: P13_dementia diagnostic Read
E012000 Chronic alcoholic brain syndrome res53: P13_dementia diagnostic Read
E02y100 Drug-induced dementia res53: P13_dementia diagnostic Read
E041.00 Dementia in conditions EC res53: P13_dementia diagnostic Read
Eu00.00 [X]Dementia in Alzheimer's disease res53: P13_dementia diagnostic Read
Eu00000 [X]Dementia in Alzheimer's disease with early onset res53: P13_dementia diagnostic Read
Eu00011 [X]Presenile dementia,Alzheimer's type res53: P13_dementia diagnostic Read
Eu00012 [X]Primary degen dementia, Alzheimer's type, presenile onset res53: P13_dementia diagnostic Read
Eu00013 [X]Alzheimer's disease type 2 res53: P13_dementia diagnostic Read
Eu00100 [X]Dementia in Alzheimer's disease with late onset res53: P13_dementia diagnostic Read
Eu00111 [X]Alzheimer's disease type 1 res53: P13_dementia diagnostic Read
Eu00112 [X]Senile dementia,Alzheimer's type res53: P13_dementia diagnostic Read
Eu00113 [X]Primary degen dementia of Alzheimer's type, senile onset res53: P13_dementia diagnostic Read
Eu00200 [X]Dementia in Alzheimer's dis, atypical or mixed type res53: P13_dementia diagnostic Read
Eu00z00 [X]Dementia in Alzheimer's disease, unspecified res53: P13_dementia diagnostic Read
Eu00z11 [X]Alzheimer's dementia unspec res53: P13_dementia diagnostic Read
Eu01.00 [X]Vascular dementia res53: P13_dementia diagnostic Read
Eu01.11 [X]Arteriosclerotic dementia res53: P13_dementia diagnostic Read
Eu01000 [X]Vascular dementia of acute onset res53: P13_dementia diagnostic Read
Eu01100 [X]Multi-infarct dementia res53: P13_dementia diagnostic Read
Eu01111 [X]Predominantly cortical dementia res53: P13_dementia diagnostic Read
Eu01200 [X]Subcortical vascular dementia res53: P13_dementia diagnostic Read
Eu01300 [X]Mixed cortical and subcortical vascular dementia res53: P13_dementia diagnostic Read
Eu01y00 [X]Other vascular dementia res53: P13_dementia diagnostic Read
Eu01z00 [X]Vascular dementia, unspecified res53: P13_dementia diagnostic Read
Eu02.00 [X]Dementia in other diseases classified elsewhere res53: P13_dementia diagnostic Read
Eu02000 [X]Dementia in Pick's disease res53: P13_dementia diagnostic Read
Eu02100 [X]Dementia in Creutzfeldt-Jakob disease res53: P13_dementia diagnostic Read
Eu02200 [X]Dementia in Huntington's disease res53: P13_dementia diagnostic Read
Eu02300 [X]Dementia in Parkinson's disease res53: P13_dementia diagnostic Read
Eu02400 [X]Dementia in human immunodef virus [HIV] disease res53: P13_dementia diagnostic Read
Eu02500 [X]Lewy body dementia res53: P13_dementia diagnostic Read
Eu02y00 [X]Dementia in other specified diseases classif elsewhere res53: P13_dementia diagnostic Read
Eu02z00 [X] Unspecified dementia res53: P13_dementia diagnostic Read
Eu02z11 [X] Presenile dementia NOS res53: P13_dementia diagnostic Read
Eu02z12 [X] Presenile psychosis NOS res53: P13_dementia diagnostic Read
Eu02z13 [X] Primary degenerative dementia NOS res53: P13_dementia diagnostic Read
Eu02z14 [X] Senile dementia NOS res53: P13_dementia diagnostic Read
Eu02z15 [X] Senile psychosis NOS res53: P13_dementia diagnostic Read
Eu02z16 [X] Senile dementia, depressed or paranoid type res53: P13_dementia diagnostic Read
Eu04100 [X]Delirium superimposed on dementia res53: P13_dementia diagnostic Read
Eu05700 [X]Mild cognitive disorder res53: P13_dementia diagnostic Read
F110.00 Alzheimer's disease res53: P13_dementia diagnostic Read
F110000 Alzheimer's disease with early onset res53: P13_dementia diagnostic Read
F110100 Alzheimer's disease with late onset res53: P13_dementia diagnostic Read
F111.00 Pick's disease res53: P13_dementia diagnostic Read
F1110A res53: P13_dementia diagnostic Read
F112.00 Senile degeneration of brain res53: P13_dementia diagnostic Read
F116.00 Lewy body disease res53: P13_dementia diagnostic Read
F118.00 res53: P13_dementia diagnostic Read
F11x.00 Cerebral degeneration in other disease EC res53: P13_dementia diagnostic Read
F11x000 Cerebral degeneration due to alcoholism res53: P13_dementia diagnostic Read
F11x011 Alcoholic encephalopathy res53: P13_dementia diagnostic Read
F11x200 Cerebral degeneration due to cerebrovascular disease res53: P13_dementia diagnostic Read
F11x400 Cerebral degeneration due to neoplastic disease res53: P13_dementia diagnostic Read
F11x500 Cerebral degeneration due to myxoedema res53: P13_dementia diagnostic Read
F11x600 Cerebral degeneration due to vitamin B12 deficiency res53: P13_dementia diagnostic Read
F11x700 Cerebral degeneration due to Jakob - Creutzfeldt disease res53: P13_dementia diagnostic Read
F11x800 Cerebral degeneration due to multifocal leucoencephalopathy res53: P13_dementia diagnostic Read
F11x900 Cerebral degeneration in Parkinson's disease res53: P13_dementia diagnostic Read
F11xz00 Cerebral degeneration other disease NOS res53: P13_dementia diagnostic Read
F11y.00 Other cerebral degeneration res53: P13_dementia diagnostic Read
F11y000 Reye's syndrome res53: P13_dementia diagnostic Read
F11y100 Cerebral ataxia res53: P13_dementia diagnostic Read
F11yz00 Other cerebral degeneration NOS res53: P13_dementia diagnostic Read
F11z.00 Cerebral degeneration NOS res53: P13_dementia diagnostic Read
F11z.11 Cerebral atrophy res53: P13_dementia diagnostic Read
F134.00 Huntington's chorea res53: P13_dementia diagnostic Read
Fyu3000 [X]Other Alzheimer's disease res53: P13_dementia diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH659/version/1318/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH659/version/1318/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('PH659', '1318', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH659/version/1318/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH659/version/1318/export/codes/?format=json
CSV site_root/phenotypes/PH659/version/1318/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('PH659', '1318', api_client=client)

Version History

Version
ID
Name Owner Publish date
1318 Dementia (P13) 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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