Data Resource Profile: The Scottish National Prescribing Information System (PIS)

Alvarez-Madrazo, Samantha; McTaggart, Stuart; Nangle, Clifford; Nicholson, Elizabeth; Bennie, Marion

doi:10.1093/ije/dyw060

Cited by 128 publications

(155 citation statements)

References 21 publications

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“…We also lack information on the type of coronary lesion and the type of stents used in revascularisation group. The use of over-the-counter medicines was not available21 in this study that could be potential confounding factors. Patients in Scotland receive free prescriptions, which should reduce the possibility of over-the-counter medicine use.…”

Section: Discussionmentioning

confidence: 94%

Cessation of dual antiplatelet therapy and cardiovascular events following acute coronary syndrome

Mazlan-Kepli

Dawson

Berry

et al. 2018

Heart

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and KeywordsObjective To assess whether cardiovascular events are increased after cessation of dual antiplatelet therapy (DAPT) following acute coronary syndrome and to explore predictors for recurrent events after DAPT cessation during long-term follow-up. MethodsWe did a retrospective observational cohort study. We included consecutive people with acute coronary syndrome (ACS) who were discharged from Scottish hospitals between January 2008 and December 2013 and who received DAPT after discharge followed by antiplatelet monotherapy. The rates of cardiovascular events were assessed during each 90-day period of DAPT treatment and 90-day period after stopping DAPT. Cardiovascular events were defined as a composite of death, ACS, transient ischaemic attack or stroke. Cox regression was used to identify predictors of cardiovascular events following DAPT cessation.Results 1340 patients were included (62% male, mean age 64.9(13.0) years). Cardiovascular events occurred in 15.7% (n=211) during the DAPT period (mean DAPT duration 175.1(155.3) days) and in 16.7% (n=188) following DAPT cessation (mean of 2.7 years follow-up).Independent predictors for a cardiovascular event following DAPT cessation were age (hazard ratio (HR) 1.07; 95% confidence interval (CI) 1.05-1.08; p<0.001), DAPT duration (HR 0.997; 95% CI 0.995-0.998; p<0.001) and having revascularization therapy during the index admission (HR 0.58; 95% CI 0.39-0.85; p=0.005). ConclusionsThe rate of cardiovascular events was not significantly increased in the early period post DAPT cessation compared to later periods in this ACS population. Increasing age, DAPT duration and lack of revascularization therapy were associated with increased risk of cardiovascular events during long term follow up after DAPT cessation. Keywords: antiplatelets, DAPT, cardiovascular events, ACS;Word count : 250 words Key messagesWhat is already known on this subject?Discontinuation of dual antiplatelet therapy (DAPT) is associated with an increased risk of cardiovascular disease in previous studies. The association between the duration of DAPT and DAPT cessation is unknown. What might this study add?We found that increasing age, DAPT duration and lack of revascularization therapy for the ACS were associated with increased risk of cardiovascular events during long term follow up after DAPT cessation. How might this impact on clinical practice?Our findings indicate that longer duration of DAPT and use of revascularization therapy may be related to a reduced risk of cardiovascular event after ACS and DAPT cessation.

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Section: Discussionmentioning

confidence: 94%

Cessation of dual antiplatelet therapy and cardiovascular events following acute coronary syndrome

Mazlan-Kepli

Dawson

Berry

et al. 2018

Heart

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“…Due to the lack of electronic reporting systems currently in Kosovo, unlike in the Nordic countries and Scotland as well as other central and eastern European countries [19–25], these data have to be manually recorded. Kosovo’s pharmaceutical sector has two main parts: the private sector where drug dispensing for ambulatory care patients is achieved through the 621 pharmacies in the country [26]; and the public sector, which includes hospitals supplied with medicines from the Essential Medicines List, previously procured through the central procurement of the MoH—these medicines are provided only to hospitalized patients.…”

Section: Methodsmentioning

confidence: 99%

Utilization and Expenditure of Anti-cancer Medicines in Kosovo: Findings and Implications

Jakupi

Godman

Martin

et al. 2018

PharmacoEconomics Open

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Background and ObjectiveThe Ministry of Health (MoH) leads and organizes health policy in Kosovo, which includes procurement and provision of medicines, including anti-cancer medicines, which compose a special group of medicines. However, there has been limited analysis of the utilization and expenditure on anti-cancer medicines in Kosovo; consequently, the objective of this study is to undertake research to provide future guidance on the use of anti-cancer medicines.MethodNational drug utilization data is available in Kosovo. Utilization and expenditure on anti-cancer medicines [Anatomical Therapeutic Chemical (ATC) code L], initially from 2011 to 2013, especially for anti-cancer medicines on the essential medicines list was analysed from national data. In addition, current systems for procuring and managing anti-cancer medicines in Kosovo was documented.ResultsThere was appreciable variability in the utilization of anti-cancer medicines over the years, with low or limited use of some anti-cancer medicines on the Essential Medicine List. This is a concern in view of their essential medicine status. From 2011 to 2013, €16.49 million was spent on anti-cancer medicines (ATC L). The process of selection of new medicines begins with suggestions from doctors at the University Clinical Centre in Kosovo.ConclusionThe analysis has shown appreciable variation with current utilization patterns for anti-cancer medicines in Kosovo. This needs to be addressed as part of improving the drug management process to optimize patient care within available resources. Future years and reforms need to be assessed to improve current utilization and expenditure patterns.

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“…Cancer recurrence was investigated previously in the Danish cohort [16] (although the earlier analysis was based on fewer than 20% of the breast cancer patients included in the present analysis and did not investigate mortality). Previous studies have reported detailed descriptions of the medication data available and/or linkages available in the cohorts from Denmark [18–20], England [21], the Netherlands [22, 23], Northern Ireland [24], Belgium [25], Republic of Ireland [26], Scotland [27] and Sweden [28, 29]. …”

Section: Methodsmentioning

confidence: 99%

Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

Cardwell

Pottegård

Vaes³

et al. 2016

Breast Cancer Res

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BackgroundPreclinical studies have demonstrated that propranolol inhibits several pathways involved in breast cancer progression and metastasis. We investigated whether breast cancer patients who used propranolol, or other non-selective beta-blockers, had reduced breast cancer-specific or all-cause mortality in eight European cohorts.MethodsIncident breast cancer patients were identified from eight cancer registries and compiled through the European Cancer Pharmacoepidemiology Network. Propranolol and non-selective beta-blocker use was ascertained for each patient. Breast cancer-specific and all-cause mortality were available for five and eight cohorts, respectively. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for cancer-specific and all-cause mortality by propranolol and non-selective beta-blocker use. HRs were pooled across cohorts using meta-analysis techniques. Dose–response analyses by number of prescriptions were also performed. Analyses were repeated investigating propranolol use before cancer diagnosis.ResultsThe combined study population included 55,252 and 133,251 breast cancer patients in the analysis of breast cancer-specific and all-cause mortality respectively. Overall, there was no association between propranolol use after diagnosis of breast cancer and breast cancer-specific or all-cause mortality (fully adjusted HR = 0.94, 95% CI, 0.77, 1.16 and HR = 1.09, 95% CI, 0.93, 1.28, respectively). There was little evidence of a dose–response relationship. There was also no association between propranolol use before breast cancer diagnosis and breast cancer-specific or all-cause mortality (fully adjusted HR = 1.03, 95% CI, 0.86, 1.22 and HR = 1.02, 95% CI, 0.94, 1.10, respectively). Similar null associations were observed for non-selective beta-blockers.ConclusionsIn this large pooled analysis of breast cancer patients, use of propranolol or non-selective beta-blockers was not associated with improved survival.

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Data Resource Profile: The Scottish National Prescribing Information System (PIS)

Cited by 128 publications

References 21 publications

Cessation of dual antiplatelet therapy and cardiovascular events following acute coronary syndrome

Cessation of dual antiplatelet therapy and cardiovascular events following acute coronary syndrome

Utilization and Expenditure of Anti-cancer Medicines in Kosovo: Findings and Implications

Propranolol and survival from breast cancer: a pooled analysis of European breast cancer cohorts

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