Changes in English medication safety indicators throughout the COVID-19 pandemic: a federated analysis of 57 million patients' primary care records in situ using OpenSAFELY
Fisher, L.; Hopcroft, L. E. M.; Rodgers, S.; Barrett, J.; Oliver, K.; Avery, A. J.; Evans, D.; Curtis, H.; Croker, R.; Macdonald, O.; Morley, J.; Mehrkar, A.; Bacon, S.; Davy, S.; Dillingham, I.; Evans, D.; Hickman, G.; Inglesby, P.; Morton, C. E.; Smith, B.; Ward, T.; Hulme, W.; Green, A.; Massey, J.; Walker, A. J.; Bates, C.; Cockburn, J.; Parry, J.; Hester, F.; Harper, S.; O'Hanlon, S.; Eavis, A.; Jarvis, R.; Avramov, D.; Griffiths, P.; Fowles, A.; Parkes, N.; Goldacre, B.; MacKenna, B.
Show abstract
ObjectiveTo describe the impact of the COVID-19 pandemic on safe prescribing, using the PINCER prescribing indicators; to implement complex prescribing indicators at national scale using GP data. DesignPopulation based cohort study, with the approval of NHS England using the OpenSAFELY platform. SettingElectronic health record data from 56.8 million NHS patients general practice records. ParticipantsAll NHS patients registered at a GP practice using TPP or EMIS computer systems and recorded as at risk of at least one potentially hazardous PINCER indicator between September 2019 and September 2021. Main outcome measureMonthly trends and between-practice variation for compliance with 13 PINCER measures between September 2019 and September 2021. ResultsThe indicators were successfully implemented across GP data in OpenSAFELY. Hazardous prescribing remained largely unchanged during the COVID-19 pandemic, with only small reductions in achievement of the PINCER indicators. There were transient delays in blood test monitoring for some medications, particularly ACE inhibitors. All indicators exhibited substantial recovery by September 2021. We identified 1,813,058 patients at risk of at least one hazardous prescribing event. ConclusionGood performance was maintained during the COVID-19 pandemic across a diverse range of widely evaluated measures of safe prescribing. Summary box O_TEXTBOXWHAT IS ALREADY KNOWN ON THIS TOPICO_LIPrimary care services were substantially disrupted by the COVID-19 pandemic. C_LIO_LIDisruption to safe prescribing during the pandemic has not previously been evaluated. C_LIO_LIPINCER is a nationally adopted programme of activities that aims to identify and correct hazardous prescribing in GP practices, by conducting manual audit on subgroups of practices. C_LI WHAT THIS STUDY ADDSO_LIFor the first time, we were able to successfully generate data on PINCER indicators for almost the whole population of England, in a single analysis. C_LIO_LIOur study is the most comprehensive assessment of medication safety during the COVID-19 pandemic in England, covering 95% of the population using well-validated measures. C_LIO_LIGood performance was maintained across many PINCER indicators throughout the pandemic. C_LIO_LIDelays in delivering some medication-related blood test monitoring were evident though considerable recovery was made by the end of the study period. C_LI C_TEXTBOX
Matching journals
The top 3 journals account for 50% of the predicted probability mass.
Similar papers in this journal
- OpenSAFELY NHS Service Restoration Observatory 1: describing trends and variation in primary care clinical activity for 23.3 million patients in England during the first wave of COVID-19 97%
- Variation in prescription duration for long term conditions: a cohort study in English NHS primary care using OpenPrescribing 96%
- Development and validation of a modified Cambridge Multimorbidity Score for use with internationally recognized electronic health record clinical terms (SNOMED CT) 93%
Similar papers in this journal
- Remote Covid Assessment in Primary Care (RECAP) risk prediction tool: derivation and real-world validation studies 94%
- An external validation of the QCovid risk prediction algorithm for risk of mortality from COVID-19 in adults: national validation cohort study in England 92%
- COVID-19 collateral: Indirect acute effects of the pandemic on physical and mental health in the UK 92%
Similar papers in this journal
- Patient characteristics associated with clinically coded long COVID: an OpenSAFELY study using electronic health records 92%
- A mixed-methods evaluation of patients’ views on primary care multi-disciplinary teams in Scotland 90%
- Patients’ perspectives on ecologically sustainable healthcare in general practice 89%
Similar papers in this journal
- Patterns of rates of mortality in the Clinical Practice Research Datalink 93%
- Changes in dispensing of medicines proposed for re-purposing in the first year of the COVID-19 pandemic in Australia 93%
- A qualitative exploration of barriers to efficient and effective Structured Medication Reviews in Primary Care: Findings from the DynAIRx study 92%
Similar papers in this journal
- Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study 93%
- What is the suitability of clinical vignettes in benchmarking the performance of online symptom checkers? An audit study 93%
- How many medications do doctors in primary care use? An observational study of the DU90% indicator in primary care in England. 93%
"Similar papers" are the closest papers from that journal in the model's embedding space. They show what the match is built on, but the ranking comes mostly from a classifier over the whole training set, not from these examples alone.