Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

Mechtouff, Laura; Haesebaert, Julie; Viprey, Marie; Tainturier,; Termoz, Anne; Porthault-Chatard, Sylvie; David, Jean-Stéphane; Derex, Laurent; Nighoghossian, Norbert; Schott, Anne-Marie

doi:10.1159/000488450

Cited by 6 publications

(10 citation statements)

References 38 publications

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“…Screening against the inclusion and exclusion criteria retrieved 39 (3.4%) papers using health database linkage, of which 16 (41.0%) focused on health care product use and care trajectories for the final analysis (Figure 1). Most papers were recent, with over 87% (n=14) of these papers published since 2017 (Multimedia Appendix 2 [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]). In 1 (6.3%) case included in this review, the publication corresponded to a study protocol in which the data linkage was planned with varying degrees of accuracy [28].…”

Section: Literature Search Findingsmentioning

confidence: 99%

“…In 1 (6.3%) case included in this review, the publication corresponded to a study protocol in which the data linkage was planned with varying degrees of accuracy [28]. Data linkage was performed at the national level (ie, for all patients with a disease or who received therapy in France) in 7 (43.8%) cases [27][28][29][30][31][32][33] or at the local level in 9 (56.2%) studies [34][35][36][37][38][39][40][41][42]. The number of patients included in the different databases (medicoadministrative, registries, cohorts, etc) varied greatly, ranging from 713 patients [34] to 75,000 patients [39,41].…”

Section: Literature Search Findingsmentioning

confidence: 99%

“…Data linkage was performed at the national level (ie, for all patients with a disease or who received therapy in France) in 7 (43.8%) cases [27][28][29][30][31][32][33] or at the local level in 9 (56.2%) studies [34][35][36][37][38][39][40][41][42]. The number of patients included in the different databases (medicoadministrative, registries, cohorts, etc) varied greatly, ranging from 713 patients [34] to 75,000 patients [39,41]. The number of patients resulting from data linkage was also variable, ranging from 210 patients [34] to 31,000 linked patients [27].…”

Section: Literature Search Findingsmentioning

confidence: 99%

“…The number of patients included in the different databases (medicoadministrative, registries, cohorts, etc) varied greatly, ranging from 713 patients [34] to 75,000 patients [39,41]. The number of patients resulting from data linkage was also variable, ranging from 210 patients [34] to 31,000 linked patients [27].…”

Section: Literature Search Findingsmentioning

confidence: 99%

“…The health products covered by the studies included drugs (anticoagulants or antiplatelet agents [34,[36][37][38], 5-alpha-reductase inhibitors [39,41], immunosuppressive treatments [32,33], antihypertensive drugs [31,34], and statins [34]) and medical devices (transcatheter aortic valve implantation [27]). The diseases studied were mainly chronic diseases (chronic kidney disease [28][29][30][31][32][33]35]; cancer [35,39,41]; cardiovascular diseases, eg, arterial hypertension [40], aortic stenosis [27], stroke [34]; diabetes [40]) and infections [33].…”

Section: Research Areasmentioning

confidence: 99%

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Development of Indirect Health Data Linkage on Health Product Use and Care Trajectories in France: Systematic Review

Ranchon¹,

Chanoine²,

Lambert-Lacroix³

et al. 2023

J Med Internet Res

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Background European national disparities in the integration of data linkage (ie, being able to match patient data between databases) into routine public health activities were recently highlighted. In France, the claims database covers almost the whole population from birth to death, offering a great research potential for data linkage. As the use of a common unique identifier to directly link personal data is often limited, linkage with a set of indirect key identifiers has been developed, which is associated with the linkage quality challenge to minimize errors in linked data. Objective The aim of this systematic review is to analyze the type and quality of research publications on indirect data linkage on health product use and care trajectories in France. Methods A comprehensive search for all papers published in PubMed/Medline and Embase databases up to December 31, 2022, involving linked French database focusing on health products use or care trajectories was realized. Only studies based on the use of indirect identifiers were included (ie, without a unique personal identifier available to easily link the databases). A descriptive analysis of data linkage with quality indicators and adherence to the Bohensky framework for evaluating data linkage studies was also realized. Results In total, 16 papers were selected. Data linkage was performed at the national level in 7 (43.8%) cases or at the local level in 9 (56.2%) studies. The number of patients included in the different databases and resulting from data linkage varied greatly, respectively, from 713 to 75,000 patients and from 210 to 31,000 linked patients. The diseases studied were mainly chronic diseases and infections. The objectives of the data linkage were multiple: to estimate the risk of adverse drug reactions (ADRs; n=6, 37.5%), to reconstruct the patient’s care trajectory (n=5, 31.3%), to describe therapeutic uses (n=2, 12.5%), to evaluate the benefits of treatments (n=2, 12.5%), and to evaluate treatment adherence (n=1, 6.3%). Registries are the most frequently linked databases with French claims data. No studies have looked at linking with a hospital data warehouse, a clinical trial database, or patient self-reported databases. The linkage approach was deterministic in 7 (43.8%) studies, probabilistic in 4 (25.0%) studies, and not specified in 5 (31.3%) studies. The linkage rate was mainly from 80% to 90% (reported in 11/15, 73.3%, studies). Adherence to the Bohensky framework for evaluating data linkage studies showed that the description of the source databases for the linkage was always performed but that the completion rate and accuracy of the variables to be linked were not systematically described. Conclusions This review highlights the growing interest in health data linkage in France. Nevertheless, regulatory, technical, and human constraints remain major obstacles to their deployment. The volume, variety, and validity of the data represent a real challenge, and advanced expertise and skills in statistical analysis and artificial intelligence are required to treat these big data.

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Section: Literature Search Findingsmentioning

confidence: 99%

Section: Literature Search Findingsmentioning

confidence: 99%

Section: Literature Search Findingsmentioning

confidence: 99%

Section: Literature Search Findingsmentioning

confidence: 99%

Section: Research Areasmentioning

confidence: 99%

See 3 more Smart Citations

Development of Indirect Health Data Linkage on Health Product Use and Care Trajectories in France: Systematic Review

Ranchon¹,

Chanoine²,

Lambert-Lacroix³

et al. 2023

J Med Internet Res

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Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta‐analysis

et al. 2022

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Objectives We aimed to investigate the prescription of antithrombotic drugs (including anticoagulants and antiplatelets) and medication adherence after stroke. Methods We performed a systematic literature search across MEDLINE and Embase, from January 1, 2015, to February 17, 2022, to identify studies reporting antithrombotic medications (anticoagulants and antiplatelets) post stroke. Two people independently identified reports to include, extracted data, and assessed the quality of included studies according to the Newcastle–Ottawa scale. Where possible, data were pooled using random‐effects meta‐analysis. Results We included 453,625 stroke patients from 46 studies. The pooled proportion of prescribed antiplatelets and anticoagulants among patients with atrial fibrillation (AF) was 62% (95% CI: 57%–68%), and 68% (95% CI: 58%–79%), respectively. The pooled proportion of patients who were treated according to the recommendation of guidelines of antithrombotic medications from four studies was 67% (95% CI: 41%–93%). It was reported that 11% (95% CI: 2%–19%) of patients did not receive antithrombotic medications. Good adherence to antiplatelet, anticoagulant, and antithrombotic medications was 78% (95% CI: 67%–89%), 71% (95% CI: 57%–84%), and 73% (95% CI: 59%–86%), respectively. Conclusion In conclusion, we found that less than 70% of patients were prescribed and treated according to the recommended guidelines of antithrombotic medications, and good adherence to antithrombotic medications is only 73%. Prescription rate and good adherence to antithrombotic medications still need to be improved among stroke survivors.

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Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies

et al. 2019

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Secondary Prevention Three and Six Years after Stroke Using the French National Insurance Healthcare System Database

Cited by 6 publications

References 38 publications

Development of Indirect Health Data Linkage on Health Product Use and Care Trajectories in France: Systematic Review

Development of Indirect Health Data Linkage on Health Product Use and Care Trajectories in France: Systematic Review

Antithrombotics prescription and adherence among stroke survivors: A systematic review and meta‐analysis

Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies

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