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Breast Cancer Gene (P19)

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

Type
Disease or Syndrome
ID
PH678
Version ID
1356
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: 26
Code Description Entity type Category Coding System (Read)
B34..00 Malignant neoplasm of female breast res25: P19_brca diagnostic Read
B34..11 Ca female breast res25: P19_brca diagnostic Read
B340.00 Malignant neoplasm of nipple and areola of female breast res25: P19_brca diagnostic Read
B340000 Malignant neoplasm of nipple of female breast res25: P19_brca diagnostic Read
B340100 Malignant neoplasm of areola of female breast res25: P19_brca diagnostic Read
B340z00 Malignant neoplasm of nipple or areola of female breast NOS res25: P19_brca diagnostic Read
B341.00 Malignant neoplasm of central part of female breast res25: P19_brca diagnostic Read
B342.00 Malignant neoplasm of upper-inner quadrant of female breast res25: P19_brca diagnostic Read
B343.00 Malignant neoplasm of lower-inner quadrant of female breast res25: P19_brca diagnostic Read
B344.00 Malignant neoplasm of upper-outer quadrant of female breast res25: P19_brca diagnostic Read
B345.00 Malignant neoplasm of lower-outer quadrant of female breast res25: P19_brca diagnostic Read
B346.00 Malignant neoplasm of axillary tail of female breast res25: P19_brca diagnostic Read
B347.00 Malignant neoplasm, overlapping lesion of breast res25: P19_brca diagnostic Read
B34y.00 Malignant neoplasm of other site of female breast res25: P19_brca diagnostic Read
B34y000 Malignant neoplasm of ectopic site of female breast res25: P19_brca diagnostic Read
B34yz00 Malignant neoplasm of other site of female breast NOS res25: P19_brca diagnostic Read
B34z.00 Malignant neoplasm of female breast NOS res25: P19_brca diagnostic Read
B83..00 Carcinoma in situ of breast and genitourinary system res25: P19_brca diagnostic Read
B830.00 Carcinoma in situ of breast res25: P19_brca diagnostic Read
B830000 Lobular carcinoma in situ of breast res25: P19_brca diagnostic Read
B830100 Intraductal carcinoma in situ of breast res25: P19_brca diagnostic Read
BB9J.00 [M]Paget's disease, mammary res25: P19_brca diagnostic Read
BB9J.11 [M]Paget's disease, breast res25: P19_brca diagnostic Read
BB9K.00 [M]Paget's disease and infiltrating breast duct carcinoma res25: P19_brca diagnostic Read
BB9K000 [M]Paget's disease and intraductal carcinoma of breast res25: P19_brca diagnostic Read
Byu6.00 [X]Malignant neoplasm of breast res25: P19_brca diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH678/version/1356/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH678/version/1356/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('PH678', '1356', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH678/version/1356/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH678/version/1356/export/codes/?format=json
CSV site_root/phenotypes/PH678/version/1356/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('PH678', '1356', api_client=client)

Version History

Version
ID
Name Owner Publish date
1356 Breast Cancer Gene (P19) 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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