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Amiodarone (M2)

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

Type
Drug
ID
PH663
Version ID
1326
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: 29
Code Description Coding System (CPRD_product_code) Entity type Category
12322 Cordarone X 100 tablets (Sanofi) CPRD_product_code res25: M2_amiodarone drug
17119 Amiodarone 300mg/10ml solution for injection pre-filled syringes CPRD_product_code res25: M2_amiodarone drug
188 Amiodarone 200mg tablets CPRD_product_code res25: M2_amiodarone drug
27161 Amidox 200mg Tablet (Berk Pharmaceuticals Ltd) CPRD_product_code res25: M2_amiodarone drug
27193 Cordarone X 150mg/3ml solution for injection ampoules (Sanofi) CPRD_product_code res25: M2_amiodarone drug
29456 Amiodarone 200mg tablets (Sandoz Ltd) CPRD_product_code res25: M2_amiodarone drug
31209 Amiodarone 100mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: M2_amiodarone drug
32164 Amiodarone 200mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: M2_amiodarone drug
32553 Amyben 100mg tablets (Lexon (UK) Ltd) CPRD_product_code res25: M2_amiodarone drug
33119 Amiodarone 150mg/3ml solution for injection ampoules CPRD_product_code res25: M2_amiodarone drug
34515 Amiodarone 200mg tablets (Generics (UK) Ltd) CPRD_product_code res25: M2_amiodarone drug
34751 Amiodarone 200mg tablets (Zentiva) CPRD_product_code res25: M2_amiodarone drug
34851 Amiodarone 200mg tablets (Teva UK Ltd) CPRD_product_code res25: M2_amiodarone drug
35517 Amiodarone 25mg/5ml oral suspension CPRD_product_code res25: M2_amiodarone drug
41530 Amiodarone 200mg tablets (IVAX Pharmaceuticals UK Ltd) CPRD_product_code res25: M2_amiodarone drug
41551 Amiodarone 100mg tablets (IVAX Pharmaceuticals UK Ltd) CPRD_product_code res25: M2_amiodarone drug
46938 Amiodarone 200mg tablets (Actavis UK Ltd) CPRD_product_code res25: M2_amiodarone drug
49376 Amiodarone 100mg tablets (Medreich Plc) CPRD_product_code res25: M2_amiodarone drug
50241 Amiodarone 200mg/5ml oral suspension CPRD_product_code res25: M2_amiodarone drug
53658 Amiodarone 100mg/5ml oral suspension CPRD_product_code res25: M2_amiodarone drug
53666 Amiodarone 100mg/5ml oral solution CPRD_product_code res25: M2_amiodarone drug
54224 Amiodarone 100mg tablets (Actavis UK Ltd) CPRD_product_code res25: M2_amiodarone drug
54608 Amiodarone 20mg/5ml oral suspension CPRD_product_code res25: M2_amiodarone drug
55845 Amiodarone oral solution CPRD_product_code res25: M2_amiodarone drug
56034 Amiodarone 100mg tablets (Generics (UK) Ltd) CPRD_product_code res25: M2_amiodarone drug
58033 Amiodarone 100mg tablets (Accord Healthcare Ltd) CPRD_product_code res25: M2_amiodarone drug
7445 Amiodarone 50mg/ml injection CPRD_product_code res25: M2_amiodarone drug
763 Amiodarone 100mg tablets CPRD_product_code res25: M2_amiodarone drug
8832 Cordarone X 200 tablets (Sanofi) CPRD_product_code res25: M2_amiodarone drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH663/version/1326/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH663/version/1326/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('PH663', '1326', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH663/version/1326/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH663/version/1326/export/codes/?format=json
CSV site_root/phenotypes/PH663/version/1326/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('PH663', '1326', api_client=client)

Version History

Version
ID
Name Owner Publish date
1326 Amiodarone (M2) 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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