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Peptic (P3)

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

Type
Disease or Syndrome
ID
PH685
Version ID
1370
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: 129
Code Description Entity type Category Coding System (Read)
14C1.00 H/O: peptic ulcer res25: P3_peptic diagnostic Read
14C1.11 H/O: duodenal ulcer res25: P3_peptic diagnostic Read
14C1.12 H/O: gastric ulcer res25: P3_peptic diagnostic Read
7612500 Resection of gastric ulcer by cautery res25: P3_peptic diagnostic Read
761D500 Endoscopic injection haemostasis of duodenal ulcer res25: P3_peptic diagnostic Read
761D600 Endoscopic injection haemostasis of gastric ulcer res25: P3_peptic diagnostic Read
761J.00 Operations on gastric ulcer res25: P3_peptic diagnostic Read
761J.11 Stomach ulcer operations res25: P3_peptic diagnostic Read
761J000 Closure of perforated gastric ulcer res25: P3_peptic diagnostic Read
761J100 Closure of gastric ulcer NEC res25: P3_peptic diagnostic Read
761J111 Suture of ulcer of stomach NEC res25: P3_peptic diagnostic Read
761Jy00 Other specified operation on gastric ulcer res25: P3_peptic diagnostic Read
761Jz00 Operation on gastric ulcer NOS res25: P3_peptic diagnostic Read
7627y00 Other specified operation on duodenal ulcer res25: P3_peptic diagnostic Read
7627z00 Operation on duodenal ulcer NOS res25: P3_peptic diagnostic Read
J102000 Peptic ulcer of oesophagus res25: P3_peptic diagnostic Read
J11..00 Gastric ulcer - (GU) res25: P3_peptic diagnostic Read
J11..11 Prepyloric ulcer res25: P3_peptic diagnostic Read
J11..12 Pyloric ulcer res25: P3_peptic diagnostic Read
J110.00 Acute gastric ulcer res25: P3_peptic diagnostic Read
J110000 Acute gastric ulcer without mention of complication res25: P3_peptic diagnostic Read
J110100 Acute gastric ulcer with haemorrhage res25: P3_peptic diagnostic Read
J110111 Bleeding acute gastric ulcer res25: P3_peptic diagnostic Read
J110200 Acute gastric ulcer with perforation res25: P3_peptic diagnostic Read
J110300 Acute gastric ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J110y00 Acute gastric ulcer unspecified res25: P3_peptic diagnostic Read
J110z00 Acute gastric ulcer NOS res25: P3_peptic diagnostic Read
J111.00 Chronic gastric ulcer res25: P3_peptic diagnostic Read
J111000 Chronic gastric ulcer without mention of complication res25: P3_peptic diagnostic Read
J111100 Chronic gastric ulcer with haemorrhage res25: P3_peptic diagnostic Read
J111111 Bleeding chronic gastric ulcer res25: P3_peptic diagnostic Read
J111200 Chronic gastric ulcer with perforation res25: P3_peptic diagnostic Read
J111211 Perforated chronic gastric ulcer res25: P3_peptic diagnostic Read
J111300 Chronic gastric ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J111400 Chronic gastric ulcer with obstruction res25: P3_peptic diagnostic Read
J111y00 Chronic gastric ulcer unspecified res25: P3_peptic diagnostic Read
J111z00 Chronic gastric ulcer NOS res25: P3_peptic diagnostic Read
J112.00 Anti-platelet induced gastric ulcer res25: P3_peptic diagnostic Read
J112z00 Anti-platelet induced gastric ulcer NOS res25: P3_peptic diagnostic Read
J113.00 Non steroidal anti inflammatory drug induced gastric ulcer res25: P3_peptic diagnostic Read
J113z00 Non steroidal anti inflammatory drug induced gastric ulc NOS res25: P3_peptic diagnostic Read
J11y.00 Unspecified gastric ulcer res25: P3_peptic diagnostic Read
J11y000 Unspecified gastric ulcer without mention of complication res25: P3_peptic diagnostic Read
J11y100 Unspecified gastric ulcer with haemorrhage res25: P3_peptic diagnostic Read
J11y200 Unspecified gastric ulcer with perforation res25: P3_peptic diagnostic Read
J11y400 Unspecified gastric ulcer with obstruction res25: P3_peptic diagnostic Read
J11yy00 Unspec gastric ulcer; unspec haemorrhage and/or perforation res25: P3_peptic diagnostic Read
J11yz00 Unspecified gastric ulcer NOS res25: P3_peptic diagnostic Read
J11z.00 Gastric ulcer NOS res25: P3_peptic diagnostic Read
J11z.11 Gastric erosions res25: P3_peptic diagnostic Read
J11z.12 Multiple gastric ulcers res25: P3_peptic diagnostic Read
J12..00 Duodenal ulcer - (DU) res25: P3_peptic diagnostic Read
J120.00 Acute duodenal ulcer res25: P3_peptic diagnostic Read
J120000 Acute duodenal ulcer without mention of complication res25: P3_peptic diagnostic Read
J120100 Acute duodenal ulcer with haemorrhage res25: P3_peptic diagnostic Read
J120200 Acute duodenal ulcer with perforation res25: P3_peptic diagnostic Read
J120300 Acute duodenal ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J120400 Acute duodenal ulcer with obstruction res25: P3_peptic diagnostic Read
J120y00 Acute duodenal ulcer unspecified res25: P3_peptic diagnostic Read
J120z00 Acute duodenal ulcer NOS res25: P3_peptic diagnostic Read
J121.00 Chronic duodenal ulcer res25: P3_peptic diagnostic Read
J121000 Chronic duodenal ulcer without mention of complication res25: P3_peptic diagnostic Read
J121100 Chronic duodenal ulcer with haemorrhage res25: P3_peptic diagnostic Read
J121111 Bleeding chronic duodenal ulcer res25: P3_peptic diagnostic Read
J121200 Chronic duodenal ulcer with perforation res25: P3_peptic diagnostic Read
J121211 Perforated chronic duodenal ulcer res25: P3_peptic diagnostic Read
J121300 Chronic duodenal ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J121400 Chronic duodenal ulcer with obstruction res25: P3_peptic diagnostic Read
J121y00 Chronic duodenal ulcer unspecified res25: P3_peptic diagnostic Read
J121z00 Chronic duodenal ulcer NOS res25: P3_peptic diagnostic Read
J122.00 Duodenal ulcer disease res25: P3_peptic diagnostic Read
J123.00 Duodenal erosion res25: P3_peptic diagnostic Read
J124.00 Recurrent duodenal ulcer res25: P3_peptic diagnostic Read
J125.00 Anti-platelet induced duodenal ulcer res25: P3_peptic diagnostic Read
J126.00 Non steroidal anti inflammatory drug induced duodenal ulcer res25: P3_peptic diagnostic Read
J12y.00 Unspecified duodenal ulcer res25: P3_peptic diagnostic Read
J12y000 Unspecified duodenal ulcer without mention of complication res25: P3_peptic diagnostic Read
J12y100 Unspecified duodenal ulcer with haemorrhage res25: P3_peptic diagnostic Read
J12y200 Unspecified duodenal ulcer with perforation res25: P3_peptic diagnostic Read
J12y300 Unspecified duodenal ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J12y400 Unspecified duodenal ulcer with obstruction res25: P3_peptic diagnostic Read
J12yy00 Unspec duodenal ulcer; unspec haemorrhage and/or perforation res25: P3_peptic diagnostic Read
J12yz00 Unspecified duodenal ulcer NOS res25: P3_peptic diagnostic Read
J12z.00 Duodenal ulcer NOS res25: P3_peptic diagnostic Read
J13..00 Peptic ulcer - (PU) site unspecified res25: P3_peptic diagnostic Read
J13..11 Stress ulcer NOS res25: P3_peptic diagnostic Read
J130.00 Acute peptic ulcer res25: P3_peptic diagnostic Read
J130000 Acute peptic ulcer without mention of complication res25: P3_peptic diagnostic Read
J130100 Acute peptic ulcer with haemorrhage res25: P3_peptic diagnostic Read
J130200 Acute peptic ulcer with perforation res25: P3_peptic diagnostic Read
J130300 Acute peptic ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J130y00 Acute peptic ulcer unspecified res25: P3_peptic diagnostic Read
J130z00 Acute peptic ulcer NOS res25: P3_peptic diagnostic Read
J131.00 Chronic peptic ulcer res25: P3_peptic diagnostic Read
J131000 Chronic peptic ulcer without mention of complication res25: P3_peptic diagnostic Read
J131100 Chronic peptic ulcer with haemorrhage res25: P3_peptic diagnostic Read
J131200 Chronic peptic ulcer with perforation res25: P3_peptic diagnostic Read
J131400 Chronic peptic ulcer with obstruction res25: P3_peptic diagnostic Read
J131y00 Chronic peptic ulcer unspecified res25: P3_peptic diagnostic Read
J131z00 Chronic peptic ulcer NOS res25: P3_peptic diagnostic Read
J13y.00 Unspecified peptic ulcer res25: P3_peptic diagnostic Read
J13y000 Unspecified peptic ulcer without mention of complication res25: P3_peptic diagnostic Read
J13y100 Unspecified peptic ulcer with haemorrhage res25: P3_peptic diagnostic Read
J13y200 Unspecified peptic ulcer with perforation res25: P3_peptic diagnostic Read
J13y300 Unspecified peptic ulcer with haemorrhage and perforation res25: P3_peptic diagnostic Read
J13y400 Unspecified peptic ulcer with obstruction res25: P3_peptic diagnostic Read
J13yz00 Unspecified peptic ulcer NOS res25: P3_peptic diagnostic Read
J13z.00 Peptic ulcer NOS res25: P3_peptic diagnostic Read
J14..00 Gastrojejunal ulcer (GJU) res25: P3_peptic diagnostic Read
J14..11 Anastomotic ulcer res25: P3_peptic diagnostic Read
J14..12 Gastrocolic ulcer res25: P3_peptic diagnostic Read
J14..13 Jejunal ulcer res25: P3_peptic diagnostic Read
J14..14 Marginal ulcer res25: P3_peptic diagnostic Read
J14..15 Stomal ulcer res25: P3_peptic diagnostic Read
J140.00 Acute gastrojejunal ulcer res25: P3_peptic diagnostic Read
J140100 Acute gastrojejunal ulcer with haemorrhage res25: P3_peptic diagnostic Read
J140200 Acute gastrojejunal ulcer with perforation res25: P3_peptic diagnostic Read
J140z00 Acute gastrojejunal ulcer NOS res25: P3_peptic diagnostic Read
J141.00 Chronic gastrojejunal ulcer res25: P3_peptic diagnostic Read
J14y.00 Unspecified gastrojejunal ulcer res25: P3_peptic diagnostic Read
J14y100 Unspecified gastrojejunal ulcer with haemorrhage res25: P3_peptic diagnostic Read
J14y200 Unspecified gastrojejunal ulcer with perforation res25: P3_peptic diagnostic Read
J14yz00 Unspecified gastrojejunal ulcer NOS res25: P3_peptic diagnostic Read
J14z.00 Gastrojejunal ulcer NOS res25: P3_peptic diagnostic Read
J173300 Duodenal scar res25: P3_peptic diagnostic Read
J17y700 Deformed duodenal cap (bulb) res25: P3_peptic diagnostic Read
J17y800 Healed gastric ulcer leaving a scar res25: P3_peptic diagnostic Read
ZV12700 [V]Personal history of digestive system disease res25: P3_peptic diagnostic Read
ZV12C00 [V] Personal history of gastric ulcer res25: P3_peptic diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH685/version/1370/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH685/version/1370/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('PH685', '1370', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH685/version/1370/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH685/version/1370/export/codes/?format=json
CSV site_root/phenotypes/PH685/version/1370/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('PH685', '1370', api_client=client)

Version History

Version
ID
Name Owner Publish date
1370 Peptic (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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