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Metformin (P8)

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

ID
PH688
Version ID
1376
Type
Drug
Data Sources
Valid event data range
Start - 01/02/2013
Sex
♀  Female ♂  Male
Agreement Date
2015-11-03
Coding system
GPRD product codes
Collections
ClinicalCodes Repository Phenotype Library
Tags
No tags

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: 92
Code Description Coding System (CPRD_product_code) Entity type Category
11601 Rosiglitazone 2mg / Metformin 500mg tablets CPRD_product_code res25: P8_metformin drug
11604 Rosiglitazone 1mg / Metformin 500mg tablets CPRD_product_code res25: P8_metformin drug
11609 Metformin with rosiglitazone 500mg + 1mg Tablet CPRD_product_code res25: P8_metformin drug
11610 Metformin with rosiglitazone 500mg + 2mg Tablet CPRD_product_code res25: P8_metformin drug
11717 Rosiglitazone 2mg / Metformin 1g tablets CPRD_product_code res25: P8_metformin drug
11737 Metformin with rosiglitazone 1000mg + 4mg Tablet CPRD_product_code res25: P8_metformin drug
11760 Metformin with rosiglitazone 1000mg + 2mg Tablet CPRD_product_code res25: P8_metformin drug
11990 Metformin 500mg/5ml oral solution sugar free CPRD_product_code res25: P8_metformin drug
14164 Avandamet 2mg/1000mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P8_metformin drug
16044 Glucophage SR 500mg tablets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
17580 Avandamet 1mg/500mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P8_metformin drug
18220 Pioglitazone 15mg / Metformin 850mg tablets CPRD_product_code res25: P8_metformin drug
23 Metformin 500mg tablets CPRD_product_code res25: P8_metformin drug
25678 Glucamet 500mg Tablet (Opus Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
26258 Glucamet 850mg Tablet (Opus Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
27501 Orabet 500mg Tablet (Lagap) CPRD_product_code res25: P8_metformin drug
30316 Metformin with pioglitazone 850mg + 15mg Tablet CPRD_product_code res25: P8_metformin drug
31077 Competact 15mg/850mg tablets (Takeda UK Ltd) CPRD_product_code res25: P8_metformin drug
31146 Metsol 500mg/5ml oral solution (Kappin Ltd) CPRD_product_code res25: P8_metformin drug
33087 Metformin 500mg tablets (Actavis UK Ltd) CPRD_product_code res25: P8_metformin drug
33674 Metformin 850mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
34004 Metformin 500mg tablets (IVAX Pharmaceuticals UK Ltd) CPRD_product_code res25: P8_metformin drug
34020 Metformin 850mg tablets (IVAX Pharmaceuticals UK Ltd) CPRD_product_code res25: P8_metformin drug
34135 Metformin 500mg Tablet (M & A Pharmachem Ltd) CPRD_product_code res25: P8_metformin drug
34323 Metformin 500mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
34504 Metformin 500mg tablets (Wockhardt UK Ltd) CPRD_product_code res25: P8_metformin drug
34598 Metformin 500mg tablets (Generics (UK) Ltd) CPRD_product_code res25: P8_metformin drug
34697 Metformin 850mg tablets (Wockhardt UK Ltd) CPRD_product_code res25: P8_metformin drug
34742 Metformin 850mg tablets (Teva UK Ltd) CPRD_product_code res25: P8_metformin drug
34836 Metformin 850mg tablets (Actavis UK Ltd) CPRD_product_code res25: P8_metformin drug
34917 Metformin 500mg tablets (Teva UK Ltd) CPRD_product_code res25: P8_metformin drug
37874 Vildagliptin 50mg / Metformin 850mg tablets CPRD_product_code res25: P8_metformin drug
37902 Vildagliptin 50mg / Metformin 1g tablets CPRD_product_code res25: P8_metformin drug
38355 Metformin 750mg modified-release tablets CPRD_product_code res25: P8_metformin drug
38400 Glucophage SR 750mg tablets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
38551 Eucreas 50mg/1000mg tablets (Novartis Pharmaceuticals UK Ltd) CPRD_product_code res25: P8_metformin drug
39203 Eucreas 50mg/850mg tablets (Novartis Pharmaceuticals UK Ltd) CPRD_product_code res25: P8_metformin drug
39560 Bolamyn SR 500mg tablets (Teva UK Ltd) CPRD_product_code res25: P8_metformin drug
39598 Metformin 1g modified-release tablets CPRD_product_code res25: P8_metformin drug
39729 Glucophage SR 1000mg tablets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
39988 Metformin 500mg oral powder sachets sugar free CPRD_product_code res25: P8_metformin drug
40007 Glucophage 1000mg oral powder sachets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
40110 Glucophage 500mg oral powder sachets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
40233 Metformin 1g oral powder sachets sugar free CPRD_product_code res25: P8_metformin drug
42161 Orabet 500mg Tablet (Sandoz Ltd) CPRD_product_code res25: P8_metformin drug
43270 Metformin 500mg/5ml oral solution sugar free (Rosemont Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
43619 Metformin 1g / Sitagliptin 50mg tablets CPRD_product_code res25: P8_metformin drug
43684 Janumet 50mg/1000mg tablets (Merck Sharp & Dohme Ltd) CPRD_product_code res25: P8_metformin drug
44250 Metformin 500mg/5ml Oral solution (Hillcross Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
45581 Metabet SR 500mg tablets (Morningside Healthcare Ltd) CPRD_product_code res25: P8_metformin drug
46989 Metabet SR 1000mg tablets (Morningside Healthcare Ltd) CPRD_product_code res25: P8_metformin drug
47939 Glucient SR 500mg tablets (Consilient Health Ltd) CPRD_product_code res25: P8_metformin drug
48149 Metformin 500mg tablets (Almus Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
49502 Glucophage SR 500mg tablets (Mawdsley-Brooks & Company Ltd) CPRD_product_code res25: P8_metformin drug
49738 Metformin 1g modified-release tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
50570 Glucophage SR 500mg tablets (Lexon (UK) Ltd) CPRD_product_code res25: P8_metformin drug
50821 Metformin 850mg tablets (Pfizer Ltd) CPRD_product_code res25: P8_metformin drug
50970 Metformin 500mg tablets (Bristol Laboratories Ltd) CPRD_product_code res25: P8_metformin drug
51080 Metabet SR 1000mg tablets (Actavis UK Ltd) CPRD_product_code res25: P8_metformin drug
51135 Metformin 500mg modified-release tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
51527 Metformin 500mg tablets (Boston Healthcare Ltd) CPRD_product_code res25: P8_metformin drug
52221 Diagemet XL 500mg tablets (Thornton & Ross Ltd) CPRD_product_code res25: P8_metformin drug
52442 Metformin 500mg tablets (Pfizer Ltd) CPRD_product_code res25: P8_metformin drug
52634 Glucophage SR 500mg tablets (DE Pharmaceuticals) CPRD_product_code res25: P8_metformin drug
53478 Metformin 500mg modified-release tablets (Kent Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
53774 Metabet SR 500mg tablets (Actavis UK Ltd) CPRD_product_code res25: P8_metformin drug
53867 Metformin 500mg tablets (Zentiva) CPRD_product_code res25: P8_metformin drug
54150 Jentadueto 2.5mg/850mg tablets (Boehringer Ingelheim Ltd) CPRD_product_code res25: P8_metformin drug
54442 Metformin (roi) 1000mg Tablet CPRD_product_code res25: P8_metformin drug
54891 Saxagliptin 2.5mg / Metformin 1g tablets CPRD_product_code res25: P8_metformin drug
54898 Metformin 850mg tablets (Almus Pharmaceuticals Ltd) CPRD_product_code res25: P8_metformin drug
55270 Duformin 500mg Tablet (Dumex Ltd) CPRD_product_code res25: P8_metformin drug
55711 Metformin 500mg tablets (Alliance Healthcare (Distribution) Ltd) CPRD_product_code res25: P8_metformin drug
55739 Metformin 500mg tablets (Tillomed Laboratories Ltd) CPRD_product_code res25: P8_metformin drug
56965 Komboglyze 2.5mg/1000mg tablets (AstraZeneca UK Ltd) CPRD_product_code res25: P8_metformin drug
57147 Bolamyn SR 1000mg tablets (Teva UK Ltd) CPRD_product_code res25: P8_metformin drug
57457 Metformin 500mg tablets (Aurobindo Pharma Ltd) CPRD_product_code res25: P8_metformin drug
58051 Metformin 500mg/5ml oral solution CPRD_product_code res25: P8_metformin drug
58607 Metformin 500mg/5ml oral solution sugar free (Zentiva) CPRD_product_code res25: P8_metformin drug
59620 Glucophage SR 500mg tablets (Waymade Healthcare Plc) CPRD_product_code res25: P8_metformin drug
60012 Dapagliflozin 5mg / Metformin 1g tablets CPRD_product_code res25: P8_metformin drug
60074 Metformin 1g modified-release tablets (Waymade Healthcare Plc) CPRD_product_code res25: P8_metformin drug
60286 Metformin 500mg/5ml oral suspension CPRD_product_code res25: P8_metformin drug
60643 Xigduo 5mg/1000mg tablets (AstraZeneca UK Ltd) CPRD_product_code res25: P8_metformin drug
6855 Avandamet 2mg/500mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P8_metformin drug
7048 Metformin 500mg modified-release tablets CPRD_product_code res25: P8_metformin drug
7166 Glucophage 500mg tablets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
7325 Avandamet 4mg/1000mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P8_metformin drug
735 Metformin 100mg/ml Oral solution CPRD_product_code res25: P8_metformin drug
7375 Rosiglitazone 4mg / Metformin 1g tablets CPRD_product_code res25: P8_metformin drug
7610 Glucophage 850mg tablets (Merck Serono Ltd) CPRD_product_code res25: P8_metformin drug
93 Metformin 850mg tablets CPRD_product_code res25: P8_metformin drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH688/version/1376/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH688/version/1376/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('PH688', '1376', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH688/version/1376/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH688/version/1376/export/codes/?format=json
CSV site_root/phenotypes/PH688/version/1376/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('PH688', '1376', api_client=client)

Version History

Version
ID
Name Owner Publish date
1376 Metformin (P8) 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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