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Chronic Pulmonary Disease

Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft

Type
Disease or Syndrome
ID
PH875
Version ID
1829
Data Sources
Valid event data range
01/01/2001 - 31/12/2014
Sex
Female, Male
Agreement Date
2018-10-15
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Background:

Self-harm is a major risk factor for suicide, with older adults (older than 65 years) having reportedly greater suicidal intent than any other age group. With the aging population rising and paucity of research focus in this age group, the extent of the problem of self-harm needs to be established. In a primary care cohort of older adults we aimed to investigate the incidence of self-harm, subsequent clinical management, prevalence of mental and physical diagnoses, and unnatural-cause mortality risk, including suicide.

Methods:

The UK Clinical Practice Research Datalink contains anonymised patient records from general practice that routinely capture clinical information pertaining to both primary and secondary care services. We identified 4124 adults aged 65 years and older with a self-harm episode ascertained from Read codes recorded during 2001–14. We calculated standardised incidence and in 2854 adults with at least 12 months follow-up examined the frequency of psychiatric referrals and prescription of psychotropic medication after self-harm. We estimated prevalence of mental and physical illness diagnoses before and after self-harm and, using Cox regression in a matched cohort, we examined cause-specific mortality risks.

Findings:

Overall incidence of self-harm in older adults aged 65 years and older was 4·1 per 10 000 person-years with stable gender-specific rates observed over the 13-year period. After self-harm, 335 (11·7%) of 2854 adults were referred to mental health services, 1692 (59·3%) were prescribed an antidepressant, and 336 (11·8%) were prescribed a tricyclic antidepressant (TCA). Having a diagnosed previous mental illness was twice as prevalent in the self-harm cohort as in the comparison cohort (prevalence ratio 2·10 [95% CI 2·03–2·17]) and with a previous physical health condition prevalence was 20% higher in the self-harm cohort compared to the comparison cohort (1·20 [1·17–1·23]). Adults from the self-harm cohort (n=2454) died from unnatural causes an estimated 20 times more frequently than the comparison cohort (n=48 921) during the first year. A markedly elevated risk of suicide (hazard ratio 145·4 [95% CI 53·9–392·3]) was observed in the self-harm cohort.

Interpretation:

Within primary care, we have identified a group of older adults at high risk from unnatural death, particularly within the first year of self-harm. We have highlighted a high frequency of prescription of TCAs, known to be potentially fatally toxic in overdose. We emphasise the need for early intervention, careful alternative prescribing, and increased support when older adults consult after an episode of self-harm and with other health conditions.

Publications

  • Catherine Morgan, Roger T Webb, Mathew J Carr, Evangelos Kontopantelis, Carolyn A Chew-Graham, Nav Kapur, Darren M. Ashcroft, Self-harm in a primary care cohort of older people incidence, clinical management, and risk of suicide and other causes of death. Psychiatry, 5, 2018.

Clinical Code List

Rows: 152
Code Description Entity type Coding System (ICD-10 Read) Category
14B4.00 H/O: asthma res69: chronic_pulmonary_disease Read diagnostic
173A.00 Exercise induced asthma res69: chronic_pulmonary_disease Read diagnostic
173c.00 Occupational asthma res69: chronic_pulmonary_disease Read diagnostic
1761 C/O bronchial catarrh res69: chronic_pulmonary_disease Read diagnostic
1O2..00 Asthma confirmed res69: chronic_pulmonary_disease Read diagnostic
663N.00 Asthma disturbing sleep res69: chronic_pulmonary_disease Read diagnostic
663N000 Asthma causing night waking res69: chronic_pulmonary_disease Read diagnostic
663N100 Asthma disturbs sleep weekly res69: chronic_pulmonary_disease Read diagnostic
663P.00 Asthma limiting activities res69: chronic_pulmonary_disease Read diagnostic
663V000 Occasional asthma res69: chronic_pulmonary_disease Read diagnostic
663V100 Mild asthma res69: chronic_pulmonary_disease Read diagnostic
663V200 Moderate asthma res69: chronic_pulmonary_disease Read diagnostic
663V300 Severe asthma res69: chronic_pulmonary_disease Read diagnostic
663W.00 Asthma prophylactic medication used res69: chronic_pulmonary_disease Read diagnostic
663e.00 Asthma restricts exercise res69: chronic_pulmonary_disease Read diagnostic
663e100 Asthma severely restricts exercise res69: chronic_pulmonary_disease Read diagnostic
663f.00 Asthma never restricts exercise res69: chronic_pulmonary_disease Read diagnostic
663h.00 Asthma - currently dormant res69: chronic_pulmonary_disease Read diagnostic
663p.00 Asthma treatment compliance unsatisfactory res69: chronic_pulmonary_disease Read diagnostic
663q.00 Asthma daytime symptoms res69: chronic_pulmonary_disease Read diagnostic
663r.00 Asthma causes night symptoms 1 to 2 times per month res69: chronic_pulmonary_disease Read diagnostic
663s.00 Asthma never causes daytime symptoms res69: chronic_pulmonary_disease Read diagnostic
663t.00 Asthma causes daytime symptoms 1 to 2 times per month res69: chronic_pulmonary_disease Read diagnostic
663u.00 Asthma causes daytime symptoms 1 to 2 times per week res69: chronic_pulmonary_disease Read diagnostic
663v.00 Asthma causes daytime symptoms most days res69: chronic_pulmonary_disease Read diagnostic
663w.00 Asthma limits walking up hills or stairs res69: chronic_pulmonary_disease Read diagnostic
66YC.00 Absent from work or school due to asthma res69: chronic_pulmonary_disease Read diagnostic
66YP.00 Asthma night-time symptoms res69: chronic_pulmonary_disease Read diagnostic
8H2P.00 Emergency admission, asthma res69: chronic_pulmonary_disease Read diagnostic
9OJ1.00 Attends asthma monitoring res69: chronic_pulmonary_disease Read diagnostic
9OJA.11 Asthma monitored res69: chronic_pulmonary_disease Read diagnostic
H30..00 Bronchitis unspecified res69: chronic_pulmonary_disease Read diagnostic
H30..11 Chest infection - unspecified bronchitis res69: chronic_pulmonary_disease Read diagnostic
H300.00 Tracheobronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H30z.00 Bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H31..00 Chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H310.00 Simple chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H310000 Chronic catarrhal bronchitis res69: chronic_pulmonary_disease Read diagnostic
H310100 Smokers' cough res69: chronic_pulmonary_disease Read diagnostic
H310z00 Simple chronic bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H311.00 Mucopurulent chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H311000 Purulent chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H311100 Fetid chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H311z00 Mucopurulent chronic bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H312.00 Obstructive chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H312000 Chronic asthmatic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H312011 Chronic wheezy bronchitis res69: chronic_pulmonary_disease Read diagnostic
H312100 Emphysematous bronchitis res69: chronic_pulmonary_disease Read diagnostic
H312z00 Obstructive chronic bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H313.00 Mixed simple and mucopurulent chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H31y.00 Other chronic bronchitis res69: chronic_pulmonary_disease Read diagnostic
H31y100 Chronic tracheobronchitis res69: chronic_pulmonary_disease Read diagnostic
H31yz00 Other chronic bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H31z.00 Chronic bronchitis NOS res69: chronic_pulmonary_disease Read diagnostic
H32..00 Emphysema res69: chronic_pulmonary_disease Read diagnostic
H320.00 Chronic bullous emphysema res69: chronic_pulmonary_disease Read diagnostic
H320000 Segmental bullous emphysema res69: chronic_pulmonary_disease Read diagnostic
H320200 Giant bullous emphysema res69: chronic_pulmonary_disease Read diagnostic
H320z00 Chronic bullous emphysema NOS res69: chronic_pulmonary_disease Read diagnostic
H321.00 Panlobular emphysema res69: chronic_pulmonary_disease Read diagnostic
H322.00 Centrilobular emphysema res69: chronic_pulmonary_disease Read diagnostic
H32y.00 Other emphysema res69: chronic_pulmonary_disease Read diagnostic
H32y000 Acute vesicular emphysema res69: chronic_pulmonary_disease Read diagnostic
H32y100 Atrophic (senile) emphysema res69: chronic_pulmonary_disease Read diagnostic
H32y200 MacLeod's unilateral emphysema res69: chronic_pulmonary_disease Read diagnostic
H32yz00 Other emphysema NOS res69: chronic_pulmonary_disease Read diagnostic
H32z.00 Emphysema NOS res69: chronic_pulmonary_disease Read diagnostic
H33..00 Asthma res69: chronic_pulmonary_disease Read diagnostic
H33..11 Bronchial asthma res69: chronic_pulmonary_disease Read diagnostic
H330.00 Extrinsic (atopic) asthma res69: chronic_pulmonary_disease Read diagnostic
H330.12 Childhood asthma res69: chronic_pulmonary_disease Read diagnostic
H330.13 Hay fever with asthma res69: chronic_pulmonary_disease Read diagnostic
H330.14 Pollen asthma res69: chronic_pulmonary_disease Read diagnostic
H330000 Extrinsic asthma without status asthmaticus res69: chronic_pulmonary_disease Read diagnostic
H330011 Hay fever with asthma res69: chronic_pulmonary_disease Read diagnostic
H330111 Extrinsic asthma with asthma attack res69: chronic_pulmonary_disease Read diagnostic
H330z00 Extrinsic asthma NOS res69: chronic_pulmonary_disease Read diagnostic
H331.00 Intrinsic asthma res69: chronic_pulmonary_disease Read diagnostic
H331.11 Late onset asthma res69: chronic_pulmonary_disease Read diagnostic
H331000 Intrinsic asthma without status asthmaticus res69: chronic_pulmonary_disease Read diagnostic
H331100 Intrinsic asthma with status asthmaticus res69: chronic_pulmonary_disease Read diagnostic
H331111 Intrinsic asthma with asthma attack res69: chronic_pulmonary_disease Read diagnostic
H331z00 Intrinsic asthma NOS res69: chronic_pulmonary_disease Read diagnostic
H332.00 Mixed asthma res69: chronic_pulmonary_disease Read diagnostic
H333.00 Acute exacerbation of asthma res69: chronic_pulmonary_disease Read diagnostic
H334.00 Brittle asthma res69: chronic_pulmonary_disease Read diagnostic
H33z.00 Asthma unspecified res69: chronic_pulmonary_disease Read diagnostic
H33z000 Status asthmaticus NOS res69: chronic_pulmonary_disease Read diagnostic
H33z011 Severe asthma attack res69: chronic_pulmonary_disease Read diagnostic
H33z111 Asthma attack NOS res69: chronic_pulmonary_disease Read diagnostic
H33z200 Late-onset asthma res69: chronic_pulmonary_disease Read diagnostic
H33zz11 Exercise induced asthma res69: chronic_pulmonary_disease Read diagnostic
H33zz12 Allergic asthma NEC res69: chronic_pulmonary_disease Read diagnostic
H33zz13 Allergic bronchitis NEC res69: chronic_pulmonary_disease Read diagnostic
H34..00 Bronchiectasis res69: chronic_pulmonary_disease Read diagnostic
H340.00 Recurrent bronchiectasis res69: chronic_pulmonary_disease Read diagnostic
H341.00 Post-infective bronchiectasis res69: chronic_pulmonary_disease Read diagnostic
H34z.00 Bronchiectasis NOS res69: chronic_pulmonary_disease Read diagnostic
H35..00 Extrinsic allergic alveolitis res69: chronic_pulmonary_disease Read diagnostic
H350.00 Farmers' lung res69: chronic_pulmonary_disease Read diagnostic
H351.00 Bagassosis res69: chronic_pulmonary_disease Read diagnostic
H352.00 Bird-fancier's lung res69: chronic_pulmonary_disease Read diagnostic
H352000 Budgerigar-fanciers' lung res69: chronic_pulmonary_disease Read diagnostic
H352100 Pigeon-fanciers' lung res69: chronic_pulmonary_disease Read diagnostic
H352z00 Bird-fancier's lung NOS res69: chronic_pulmonary_disease Read diagnostic
H353.00 Suberosis ( cork-handlers' lung ) res69: chronic_pulmonary_disease Read diagnostic
H354.00 Malt workers' lung res69: chronic_pulmonary_disease Read diagnostic
H355.00 Mushroom workers' lung res69: chronic_pulmonary_disease Read diagnostic
H356.00 Maple bark strippers' lung res69: chronic_pulmonary_disease Read diagnostic
H35y.00 Other allergic alveolitis res69: chronic_pulmonary_disease Read diagnostic
H35y500 Pituitary snuff-takers' disease res69: chronic_pulmonary_disease Read diagnostic
H35y600 Sequoiosis (red-cedar asthma) res69: chronic_pulmonary_disease Read diagnostic
H35y700 Wood asthma res69: chronic_pulmonary_disease Read diagnostic
H35yz00 Other allergic alveolitis NOS res69: chronic_pulmonary_disease Read diagnostic
H35z.00 Allergic alveolitis and pneumonitis NOS res69: chronic_pulmonary_disease Read diagnostic
H35z100 Hypersensitivity pneumonitis NOS res69: chronic_pulmonary_disease Read diagnostic
H35zz00 Allergic alveolitis and pneumonitis NOS res69: chronic_pulmonary_disease Read diagnostic
H3z..11 Chronic obstructive pulmonary disease NOS res69: chronic_pulmonary_disease Read diagnostic
H40..00 Coal workers' pneumoconiosis res69: chronic_pulmonary_disease Read diagnostic
H41..00 Asbestosis res69: chronic_pulmonary_disease Read diagnostic
H410.00 Pleural plaque disease due to asbestosis res69: chronic_pulmonary_disease Read diagnostic
H41z.00 Asbestosis NOS res69: chronic_pulmonary_disease Read diagnostic
H42..00 Silica and silicate pneumoconiosis res69: chronic_pulmonary_disease Read diagnostic
H420.00 Talc pneumoconiosis res69: chronic_pulmonary_disease Read diagnostic
H423.00 Massive silicotic fibrosis res69: chronic_pulmonary_disease Read diagnostic
H42z.00 Silica pneumoconiosis NOS res69: chronic_pulmonary_disease Read diagnostic
H43..00 Pneumoconiosis due to other inorganic dust res69: chronic_pulmonary_disease Read diagnostic
H431.00 Bauxite fibrosis of lung res69: chronic_pulmonary_disease Read diagnostic
H432.00 Berylliosis res69: chronic_pulmonary_disease Read diagnostic
H434.00 Siderosis res69: chronic_pulmonary_disease Read diagnostic
H435.00 Stannosis res69: chronic_pulmonary_disease Read diagnostic
H43z.00 Pneumoconiosis due to inorganic dust NOS res69: chronic_pulmonary_disease Read diagnostic
H440.00 Byssinosis res69: chronic_pulmonary_disease Read diagnostic
H441.00 Cannabinosis res69: chronic_pulmonary_disease Read diagnostic
H45..00 Pneumoconiosis NOS res69: chronic_pulmonary_disease Read diagnostic
H460.00 Bronchitis and pneumonitis due to chemical fumes res69: chronic_pulmonary_disease Read diagnostic
H460z00 Bronchitis and pneumonitis due to chemical fumes NOS res69: chronic_pulmonary_disease Read diagnostic
H464000 Chronic emphysema due to chemical fumes res69: chronic_pulmonary_disease Read diagnostic
H464100 Obliterative bronchiolitis due to chemical fumes res69: chronic_pulmonary_disease Read diagnostic
H464200 Chronic pulmonary fibrosis due to chemical fumes res69: chronic_pulmonary_disease Read diagnostic
H47y000 Detergent asthma res69: chronic_pulmonary_disease Read diagnostic
H4y1000 Chronic pulmonary fibrosis following radiation res69: chronic_pulmonary_disease Read diagnostic
H4z..00 Lung disease due to external agents NOS res69: chronic_pulmonary_disease Read diagnostic
H57y.00 Lung disease with diseases EC res69: chronic_pulmonary_disease Read diagnostic
H57yz00 Lung disease with diseases EC NOS res69: chronic_pulmonary_disease Read diagnostic
H581.00 Interstitial emphysema res69: chronic_pulmonary_disease Read diagnostic
H582.00 Compensatory emphysema res69: chronic_pulmonary_disease Read diagnostic
Hyu3000 [X]Other emphysema res69: chronic_pulmonary_disease Read diagnostic
Hyu4000 [X]Pneumoconiosis due to other dust containing silica res69: chronic_pulmonary_disease Read diagnostic
Hyu4300 [X]Hypersensitivity pneumonitis due to other organic dusts res69: chronic_pulmonary_disease Read diagnostic
L4930LO res69: chronic_pulmonary_disease Read diagnostic
SK07.00 Subcutaneous emphysema res69: chronic_pulmonary_disease Read diagnostic
Rows: 10
Code Description Entity type Coding System (ICD-10 Read) Category
J60-J67 Lung diseases due to external agents res69: chronic_pulmonary_disease ICD-10 diagnostic
J68.4 Chronic respiratory condtions due to chemicals, gases, fumes and vapours res69: chronic_pulmonary_disease ICD-10 diagnostic
J70.1 Chronic and other pulmonary manifestations due to radiation res69: chronic_pulmonary_disease ICD-10 diagnostic
J70.3 Chronic drug-indiced interstitial lung disorders res69: chronic_pulmonary_disease ICD-10 diagnostic
J84.1 Other interstitial pulmonary diseases with fibrosis res69: chronic_pulmonary_disease ICD-10 diagnostic
J92.0 Pleural plaque res69: chronic_pulmonary_disease ICD-10 diagnostic
J40-J47 Chronic lower respiratory diseases res69: chronic_pulmonary_disease ICD-10 diagnostic
J96.1 Chronic respiratory failure res69: chronic_pulmonary_disease ICD-10 diagnostic
J98.2 Interstitial emphysema res69: chronic_pulmonary_disease ICD-10 diagnostic
J98.3 Compensatory emphysema res69: chronic_pulmonary_disease ICD-10 diagnostic

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH875/version/1829/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH875/version/1829/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('PH875', '1829', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH875/version/1829/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH875/version/1829/export/codes/?format=json
CSV site_root/phenotypes/PH875/version/1829/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('PH875', '1829', api_client=client)

Version History

Version
ID
Name Owner Publish date
1829 Chronic Pulmonary Disease ieuan.scanlon 2022-04-04 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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