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Dementia (P13)

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

Type
Disease or Syndrome
ID
PH672
Version ID
1344
Data Sources
Valid event data range
Start - 01/02/2013
Sex
Female, Male
Agreement Date
2015-11-03
Coding system
Read codes v2
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: 96
Code Description Entity type Category Coding System (Read)
A411.00 Jakob-Creutzfeldt disease res25: P13_dementia diagnostic Read
E00..00 Senile and presenile organic psychotic conditions res25: P13_dementia diagnostic Read
E00..11 Senile dementia res25: P13_dementia diagnostic Read
E00..12 Senile/presenile dementia res25: P13_dementia diagnostic Read
E000.00 Uncomplicated senile dementia res25: P13_dementia diagnostic Read
E001.00 Presenile dementia res25: P13_dementia diagnostic Read
E001000 Uncomplicated presenile dementia res25: P13_dementia diagnostic Read
E001100 Presenile dementia with delirium res25: P13_dementia diagnostic Read
E001200 Presenile dementia with paranoia res25: P13_dementia diagnostic Read
E001300 Presenile dementia with depression res25: P13_dementia diagnostic Read
E001z00 Presenile dementia NOS res25: P13_dementia diagnostic Read
E002.00 Senile dementia with depressive or paranoid features res25: P13_dementia diagnostic Read
E002000 Senile dementia with paranoia res25: P13_dementia diagnostic Read
E002100 Senile dementia with depression res25: P13_dementia diagnostic Read
E002z00 Senile dementia with depressive or paranoid features NOS res25: P13_dementia diagnostic Read
E003.00 Senile dementia with delirium res25: P13_dementia diagnostic Read
E004.00 Arteriosclerotic dementia res25: P13_dementia diagnostic Read
E004.11 Multi infarct dementia res25: P13_dementia diagnostic Read
E004000 Uncomplicated arteriosclerotic dementia res25: P13_dementia diagnostic Read
E004100 Arteriosclerotic dementia with delirium res25: P13_dementia diagnostic Read
E004200 Arteriosclerotic dementia with paranoia res25: P13_dementia diagnostic Read
E004300 Arteriosclerotic dementia with depression res25: P13_dementia diagnostic Read
E004z00 Arteriosclerotic dementia NOS res25: P13_dementia diagnostic Read
E00y.00 Other senile and presenile organic psychoses res25: P13_dementia diagnostic Read
E00y.11 Presbyophrenic psychosis res25: P13_dementia diagnostic Read
E00z.00 Senile or presenile psychoses NOS res25: P13_dementia diagnostic Read
E012.00 Other alcoholic dementia res25: P13_dementia diagnostic Read
E012.11 Alcoholic dementia NOS res25: P13_dementia diagnostic Read
E012000 Chronic alcoholic brain syndrome res25: P13_dementia diagnostic Read
E02y100 Drug-induced dementia res25: P13_dementia diagnostic Read
E041.00 Dementia in conditions EC res25: P13_dementia diagnostic Read
Eu00.00 [X]Dementia in Alzheimer's disease res25: P13_dementia diagnostic Read
Eu00000 [X]Dementia in Alzheimer's disease with early onset res25: P13_dementia diagnostic Read
Eu00011 [X]Presenile dementia,Alzheimer's type res25: P13_dementia diagnostic Read
Eu00012 [X]Primary degen dementia, Alzheimer's type, presenile onset res25: P13_dementia diagnostic Read
Eu00013 [X]Alzheimer's disease type 2 res25: P13_dementia diagnostic Read
Eu00100 [X]Dementia in Alzheimer's disease with late onset res25: P13_dementia diagnostic Read
Eu00111 [X]Alzheimer's disease type 1 res25: P13_dementia diagnostic Read
Eu00112 [X]Senile dementia,Alzheimer's type res25: P13_dementia diagnostic Read
Eu00113 [X]Primary degen dementia of Alzheimer's type, senile onset res25: P13_dementia diagnostic Read
Eu00200 [X]Dementia in Alzheimer's dis, atypical or mixed type res25: P13_dementia diagnostic Read
Eu00z00 [X]Dementia in Alzheimer's disease, unspecified res25: P13_dementia diagnostic Read
Eu00z11 [X]Alzheimer's dementia unspec res25: P13_dementia diagnostic Read
Eu01.00 [X]Vascular dementia res25: P13_dementia diagnostic Read
Eu01.11 [X]Arteriosclerotic dementia res25: P13_dementia diagnostic Read
Eu01000 [X]Vascular dementia of acute onset res25: P13_dementia diagnostic Read
Eu01100 [X]Multi-infarct dementia res25: P13_dementia diagnostic Read
Eu01111 [X]Predominantly cortical dementia res25: P13_dementia diagnostic Read
Eu01200 [X]Subcortical vascular dementia res25: P13_dementia diagnostic Read
Eu01300 [X]Mixed cortical and subcortical vascular dementia res25: P13_dementia diagnostic Read
Eu01y00 [X]Other vascular dementia res25: P13_dementia diagnostic Read
Eu01z00 [X]Vascular dementia, unspecified res25: P13_dementia diagnostic Read
Eu02.00 [X]Dementia in other diseases classified elsewhere res25: P13_dementia diagnostic Read
Eu02000 [X]Dementia in Pick's disease res25: P13_dementia diagnostic Read
Eu02100 [X]Dementia in Creutzfeldt-Jakob disease res25: P13_dementia diagnostic Read
Eu02200 [X]Dementia in Huntington's disease res25: P13_dementia diagnostic Read
Eu02300 [X]Dementia in Parkinson's disease res25: P13_dementia diagnostic Read
Eu02400 [X]Dementia in human immunodef virus [HIV] disease res25: P13_dementia diagnostic Read
Eu02500 [X]Lewy body dementia res25: P13_dementia diagnostic Read
Eu02y00 [X]Dementia in other specified diseases classif elsewhere res25: P13_dementia diagnostic Read
Eu02z00 [X] Unspecified dementia res25: P13_dementia diagnostic Read
Eu02z11 [X] Presenile dementia NOS res25: P13_dementia diagnostic Read
Eu02z12 [X] Presenile psychosis NOS res25: P13_dementia diagnostic Read
Eu02z13 [X] Primary degenerative dementia NOS res25: P13_dementia diagnostic Read
Eu02z14 [X] Senile dementia NOS res25: P13_dementia diagnostic Read
Eu02z15 [X] Senile psychosis NOS res25: P13_dementia diagnostic Read
Eu02z16 [X] Senile dementia, depressed or paranoid type res25: P13_dementia diagnostic Read
Eu04100 [X]Delirium superimposed on dementia res25: P13_dementia diagnostic Read
Eu05700 [X]Mild cognitive disorder res25: P13_dementia diagnostic Read
F110.00 Alzheimer's disease res25: P13_dementia diagnostic Read
F110000 Alzheimer's disease with early onset res25: P13_dementia diagnostic Read
F110100 Alzheimer's disease with late onset res25: P13_dementia diagnostic Read
F111.00 Pick's disease res25: P13_dementia diagnostic Read
F1110A res25: P13_dementia diagnostic Read
F112.00 Senile degeneration of brain res25: P13_dementia diagnostic Read
F116.00 Lewy body disease res25: P13_dementia diagnostic Read
F118.00 res25: P13_dementia diagnostic Read
F11x.00 Cerebral degeneration in other disease EC res25: P13_dementia diagnostic Read
F11x000 Cerebral degeneration due to alcoholism res25: P13_dementia diagnostic Read
F11x011 Alcoholic encephalopathy res25: P13_dementia diagnostic Read
F11x200 Cerebral degeneration due to cerebrovascular disease res25: P13_dementia diagnostic Read
F11x400 Cerebral degeneration due to neoplastic disease res25: P13_dementia diagnostic Read
F11x500 Cerebral degeneration due to myxoedema res25: P13_dementia diagnostic Read
F11x600 Cerebral degeneration due to vitamin B12 deficiency res25: P13_dementia diagnostic Read
F11x700 Cerebral degeneration due to Jakob - Creutzfeldt disease res25: P13_dementia diagnostic Read
F11x800 Cerebral degeneration due to multifocal leucoencephalopathy res25: P13_dementia diagnostic Read
F11x900 Cerebral degeneration in Parkinson's disease res25: P13_dementia diagnostic Read
F11xz00 Cerebral degeneration other disease NOS res25: P13_dementia diagnostic Read
F11y.00 Other cerebral degeneration res25: P13_dementia diagnostic Read
F11y000 Reye's syndrome res25: P13_dementia diagnostic Read
F11y100 Cerebral ataxia res25: P13_dementia diagnostic Read
F11yz00 Other cerebral degeneration NOS res25: P13_dementia diagnostic Read
F11z.00 Cerebral degeneration NOS res25: P13_dementia diagnostic Read
F11z.11 Cerebral atrophy res25: P13_dementia diagnostic Read
F134.00 Huntington's chorea res25: P13_dementia diagnostic Read
Fyu3000 [X]Other Alzheimer's disease res25: P13_dementia diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH672/version/1344/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH672/version/1344/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('PH672', '1344', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH672/version/1344/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH672/version/1344/export/codes/?format=json
CSV site_root/phenotypes/PH672/version/1344/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('PH672', '1344', api_client=client)

Version History

Version
ID
Name Owner Publish date
1344 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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