The prevalence of COPD in England: An ontological approach to case detection in primary care

Rayner, Louise; Sherlock, Julian; Creagh-Brown, Ben; Williams, John; deLusignan, Simon

doi:10.1016/j.rmed.2017.10.024

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…The prevalence of COPD in England in 2016 was estimatedusing an ontological approachto be 4.6% among adults aged ! 35 years [20]. Based on claims data from the United States (US), individuals with COPD appear to be at increased risk of pertussis infection, as the incidence of pertussis was 1.9-3.6-fold higher among adults with COPD than matched adults without COPD or asthma [21].…”

Section: What Is the Impact?mentioning

confidence: 99%

Burden of Pertussis in COPD: A Retrospective Database Study in England

Aris

Harrington

Bhavsar

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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Chronic obstructive pulmonary disease (COPD) may increase the risk and severity of pertussis infection. Health care resource utilization (HCRU) and direct medical costs (DMC) of treating pertussis among patients with COPD are unknown. Reported incidence of pertussis among individuals aged ! 50 years with COPD was assessed in Clinical Practice Research Datalink and Hospital Episode Statistics databases during 2009-2018 using a retrospective cohort design. HCRU and DMC from the National Health Service perspective were compared between patients with COPD and pertussis and propensity score-matched patients with COPD without pertussis. Seventy-eight new pertussis events were identified among 387 086 patients with COPD aged ! 50 years (incidence rate: 4.73; 95% confidence interval 3.74-5.91 per 100 000 person-years). HCRU and DMC were assessed among 67 patients with COPD and pertussis and 267 matched controls. During the month before the pertussis diagnosis, the rates of general practitioner (GP)/nurse visits (4289 vs. 1774 per 100 patient-years) and accident and emergency visits (182 vs. 18 per 100 patient-years) were higher in the pertussis cohort; GP/nurse visits (2935 vs. 1705 per 100 patient-years) were also higher during the following 2 months (all p < 0.001). During the month before the pertussis diagnosis, annualized per-patient total DMC were £2012 higher in the pertussis cohort (£3729 vs. £1717; p < 0.001); during the following 2 months, they were £2407 higher (£5498 vs. £3091; p < 0.001). In conclusion, a pertussis episode among individuals with COPD resulted in significant increases in HCRU and DMC around the pertussis event.

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Section: What Is the Impact?mentioning

confidence: 99%

Burden of Pertussis in COPD: A Retrospective Database Study in England

Aris

Harrington

Bhavsar

et al. 2021

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…However, our ontological approach to detecting cases of AA and associated comorbidities will improve accuracy compared with the use of diagnostic codes alone. 69 70 Exclusion of individuals with potentially confounding conditions (ie, other causes of hair loss) will also improve the accuracy of our estimates. The algorithms used to detect common mental health conditions have been previously validated in UK primary care.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology, management and the associated burden of mental health illness, atopic and autoimmune conditions, and common infections in alopecia areata: protocol for an observational study series

et al. 2021

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IntroductionAlopecia areata (AA) is a common cause of immune-mediated non-scarring hair loss. Links between AA and common mental health, autoimmune and atopic conditions, and common infections have previously been described but remain incompletely elucidated and contemporary descriptions of the epidemiology of AA in the UK are lacking.Methods and analysisRetrospective study series using a large population-based cohort (5.2 million) from the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) database, exploring four themes: AA epidemiology, mental health comorbidities, autoimmune/atopic associations and common infections.In the epidemiology theme, we will describe the incidence and point prevalence of AA overall and by age, sex and sociodemographic factors. Healthcare utilisation (primary care visits and secondary care referrals) and treatments for AA will also be assessed. In the mental health theme, we will explore the prevalence and incidence of mental health conditions (anxiety, depressive episodes, recurrent depressive disorder, adjustment disorder, agoraphobia, self-harm and parasuicide) in people with AA compared with matched controls. We will also explore the mental health treatment patterns (medication and psychological interventions), time off work and unemployment rates. Within the autoimmune/atopic associations theme, we will examine the prevalence of atopic (atopic dermatitis, allergic rhinitis, asthma) and autoimmune conditions (Crohn’s disease, ulcerative colitis, coeliac disease, type 1 diabetes, Hashimoto’s thyroiditis, Graves’ disease, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE), polymyalgia rheumatica, Sjögren’s syndrome, psoriasis, vitiligo, multiple sclerosis, pernicious anaemia) in people with AA compared with matched controls. We will also estimate the incidence of new-onset atopic and autoimmune conditions after AA diagnosis. Within the common infections theme, we will examine the incidence of common infections (respiratory tract infection, pneumonia, acute bronchitis, influenza, skin infection, urinary tract infection, genital infections, gastrointestinal infection, herpes simplex, herpes zoster, meningitis, COVID-19) in people with AA compared with matched controls.Ethics and disseminationThe Health Research Authority decision tool classed this a study of usual practice, ethics approval was not required. Study approval was granted by the RCGP RSC Study Approval Committee. Results will be disseminated through peer-reviewed publications.Observational study registration numberNCT04239521.

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“…An ontological approach to AD case detection improves accuracy compared with the use of diagnostic codes alone. 23 The approach to identify AD to be used here has been validated in other similar datasets and has been shown to have an excellent positive predictive value. 25 Exclusion of individuals with potentially confounding conditions will also improve the accuracy of our estimates.…”

Section: Strengths and Limitations Of The Research Methodsmentioning

confidence: 99%

“…20 Studies in several chronic diseases such as diabetes, atrial fibrillation, chronic kidney disease, asthma and chronic obstructive pulmonary disease have been published using RCGP RSC data. [21][22][23][24] Open access Study participants' eligibility All children and adults registered with an RCGP RSC affiliated practice between 1 January 2009 and 1 January 2019 will be extracted from the RCGP RSC database and eligible for inclusion in the studies. People will be excluded if they have less than 12 months of follow-up in the database (unless aged <1 year) and if they have not had at least one consultation during the study period.…”

Section: Data Sourcementioning

confidence: 99%

Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol

et al. 2020

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IntroductionAtopic dermatitis (AD) is one of the most common inflammatory skin conditions in both children and adults. Despite this, contemporary descriptions of the incidence, prevalence and current management of the condition in the UK are lacking.Methods and analysisWe will perform a series of retrospective studies using a large population-based cohort derived from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database to explore two key research themes: AD epidemiology and AD management.In the epidemiology theme, we will describe the incidence and prevalence of AD in children and adults in England from 2009 to 2018 inclusive. We will stratify findings by age, national Index of Multiple Deprivation (IMD), ethnicity, urban-rural environment and geographic location; and explore independent associations of these features with AD in multivariable models.In the management theme, we will explore healthcare utilisation and treatment in people with AD. Regarding healthcare utilisation, we will evaluate rates of AD-associated primary care visits and specialist dermatology referrals in people with AD. Rates will be stratified by age, gender, socioeconomic IMD quintile and ethnicity. We will describe contemporary treatment by estimating prescribing rates across medication classes used in AD (emollients, topical corticosteroids by potency, topical calcineurin inhibitors, topical antimicrobials, antihistamines, oral corticosteroids and systemic immunomodulatory therapies) overall, and by age and sociodemographic groupings. We will also examine trends in prescribing over the study period. In people first diagnosed with AD during the study period, we will describe differences in treatment escalation by sociodemographic factors using time-to-event analysis.Ethics and disseminationThe Health Research Authority decision tool classed this a study of ‘usual practice’, ethics approval was not required. Study approval was granted by the RCGP RSC Study Approval Committee. Results will be disseminated through peer-reviewed publications.Trial registration numberNCT03823794.

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The prevalence of COPD in England: An ontological approach to case detection in primary care

Abstract: We demonstrate a robust reproducible method for COPD case detection in routinely collected primary care data. Our calculated prevalence differed significantly from current estimates based upon P4P data, suggesting that the burden of COPD in England is greater than currently predicted.

Cited by 12 publications

References 25 publications

Burden of Pertussis in COPD: A Retrospective Database Study in England

Burden of Pertussis in COPD: A Retrospective Database Study in England

Epidemiology, management and the associated burden of mental health illness, atopic and autoimmune conditions, and common infections in alopecia areata: protocol for an observational study series

Epidemiology and management of atopic dermatitis in England: an observational cohort study protocol

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