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Clopidogrel (P3)

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

Type
Drug
ID
PH683
Version ID
1366
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: 18
Code Description Coding System (CPRD_product_code) Entity type Category
17817 CLOPIDOGREL FC CPRD_product_code res25: P3_clopidogrel drug
38349 Clopidogrel 300mg tablets CPRD_product_code res25: P3_clopidogrel drug
38998 Plavix 300mg tablets (Sanofi) CPRD_product_code res25: P3_clopidogrel drug
40913 Grepid 75mg tablets (Beacon Pharmaceuticals Ltd) CPRD_product_code res25: P3_clopidogrel drug
42750 Clopidogrel 75mg tablets (Actavis UK Ltd) CPRD_product_code res25: P3_clopidogrel drug
45905 Clopidogrel 1mg/ml oral suspension CPRD_product_code res25: P3_clopidogrel drug
46891 Clopidogrel 75mg/5ml oral suspension CPRD_product_code res25: P3_clopidogrel drug
489 Clopidogrel 75mg tablets CPRD_product_code res25: P3_clopidogrel drug
52761 Clopidogrel 75mg tablets (Dr Reddy's Laboratories (UK) Ltd) CPRD_product_code res25: P3_clopidogrel drug
53751 Clopidogrel 75mg tablets (Phoenix Healthcare Distribution Ltd) CPRD_product_code res25: P3_clopidogrel drug
54700 Clopidogrel 75mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P3_clopidogrel drug
55161 Clopidogrel 75mg tablets (Wockhardt UK Ltd) CPRD_product_code res25: P3_clopidogrel drug
56807 Clopidogrel 75mg tablets (Teva UK Ltd) CPRD_product_code res25: P3_clopidogrel drug
57036 Clopidogrel 75mg tablets (Generics (UK) Ltd) CPRD_product_code res25: P3_clopidogrel drug
58347 Clopidogrel 75mg tablets (DE Pharmaceuticals) CPRD_product_code res25: P3_clopidogrel drug
58448 Clopidogrel 75mg tablets (Aspire Pharma Ltd) CPRD_product_code res25: P3_clopidogrel drug
59904 Clopidogrel 75mg/5ml oral solution CPRD_product_code res25: P3_clopidogrel drug
836 Plavix 75mg tablets (Sanofi) CPRD_product_code res25: P3_clopidogrel drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH683/version/1366/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH683/version/1366/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('PH683', '1366', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH683/version/1366/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH683/version/1366/export/codes/?format=json
CSV site_root/phenotypes/PH683/version/1366/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('PH683', '1366', api_client=client)

Version History

Version
ID
Name Owner Publish date
1366 Clopidogrel (P3) 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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