ClinicalCodes.org
An online clinical codes repository to improve validity and reproducibility of medical database research
Research article:
Examining variations in prescribing safety in UK general practice: a cross-sectional study using the Clinical Practice Research Datalink
Reference:
S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodger, Anthony J Avery, Darren M Ashcroft(2015) Examining variations in prescribing safety in UK general practice: a cross-sectional study using the Clinical Practice Research Datalink. BMJ, doi: 10.1136/bmj.h5501
- Link to fulltext article
- Abstract
- Study question What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices? Methods A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin. Study answer and limitations 49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators.Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in patients receiving warfarin. What this study adds The high prevalence for certain indicators emphasises existing prescribing risks and the need for their appropriate consideration within primary care, particularly for older patients and those taking multiple medications. The high variation between practices indicates potential for improvement through targeted practice level intervention.
- Author for correspondence
- Jill Stocks
- Email for correspondence
- jill.stocks@manchester.ac.uk
Code list: res25: M3_methotrexate
90 codes in list
| Code | Coding system | Description | Entity type | List name | drugsubstance | ||
|---|---|---|---|---|---|---|---|
| 12816 | CPRD_product_code | Methotrexate 100mg/ml Injection | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 13428 | CPRD_product_code | Maxtrex 2.5mg tablets (Pfizer Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 14347 | CPRD_product_code | Methotrexate 20mg/0.8ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 14348 | CPRD_product_code | Metoject 20mg/2ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 14748 | CPRD_product_code | Methotrexate sodium 25mg/ml Injection | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 16519 | CPRD_product_code | Methotrexate 25mg/1ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 16540 | CPRD_product_code | Methotrexate 15mg/0.6ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 16570 | CPRD_product_code | Methotrexate 7.5mg/0.3ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 17035 | CPRD_product_code | Methotrexate 2.5mg/5ml oral suspension | drug | res25: M3_methotrexate | Methotrexate | ||
| 17672 | CPRD_product_code | Methotrexate 22.5mg/0.9ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 18424 | CPRD_product_code | Methotrexate sodium 2.5mg Tablet | drug | res25: M3_methotrexate | Methotrexate | ||
| 18890 | CPRD_product_code | Methotrexate 17.5mg/0.7ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 20951 | CPRD_product_code | Methotrexate 2.5mg tablets (AMCo) | drug | res25: M3_methotrexate | Methotrexate | ||
| 21753 | CPRD_product_code | Maxtrex 10mg tablets (Pfizer Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 21889 | CPRD_product_code | METHOTREXATE 25MG/1ML | drug | res25: M3_methotrexate | |||
| 24634 | CPRD_product_code | Methotrexate 25mg/2.5ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 24783 | CPRD_product_code | Methotrexate 50mg/2ml Injection | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 26064 | CPRD_product_code | Methotrexate 20mg/2ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 27342 | CPRD_product_code | Maxtrex 2.5mg/ml Injection (Pharmacia Ltd) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 27400 | CPRD_product_code | Metoject 15mg/1.5ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 27404 | CPRD_product_code | Methotrexate 15mg/1.5ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 27579 | CPRD_product_code | METHOTREXATE | drug | res25: M3_methotrexate | |||
| 27642 | CPRD_product_code | Methotrexate 27.5mg/1.1ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 28041 | CPRD_product_code | Methotrexate 12.5mg/5ml oral suspension | drug | res25: M3_methotrexate | Methotrexate | ||
| 29069 | CPRD_product_code | Methotrexate 500mg/vial sterile powder | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 30703 | CPRD_product_code | Methotrexate 30mg/1.2ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 30780 | CPRD_product_code | Methotrexate 2.5mg Tablet (Pharmacia Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 30932 | CPRD_product_code | Methotrexate 5mg/0.2ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 32111 | CPRD_product_code | Methotrexate 2.5mg tablets (Hospira UK Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 32229 | CPRD_product_code | Methotrexate 500mg/20ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 32865 | CPRD_product_code | Methotrexate 10mg/1ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 33601 | CPRD_product_code | Metoject 25mg/2.5ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 34258 | CPRD_product_code | Methotrexate 20mg/0.8ml Injection (Central Homecare) | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 34929 | CPRD_product_code | Methotrexate 10mg tablets (Hospira UK Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 35402 | CPRD_product_code | Methotrexate 7.5mg/0.75ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 35752 | CPRD_product_code | Methotrexate 7.5mg/5ml oral suspension | drug | res25: M3_methotrexate | Methotrexate | ||
| 35865 | CPRD_product_code | Metoject 7.5mg/0.75ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 36167 | CPRD_product_code | Methotrexate 1g/10ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 36800 | CPRD_product_code | Methotrexate 10mg/5ml oral solution | drug | res25: M3_methotrexate | Methotrexate | ||
| 36849 | CPRD_product_code | Methotrexate 10mg/5ml oral suspension | drug | res25: M3_methotrexate | Methotrexate | ||
| 37117 | CPRD_product_code | Metoject 10mg/1ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 40273 | CPRD_product_code | Methotrexate 20mg/0.4ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 40280 | CPRD_product_code | Metoject 7.5mg/0.15ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40281 | CPRD_product_code | Methotrexate 15mg/0.3ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40284 | CPRD_product_code | Metoject 15mg/0.3ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40292 | CPRD_product_code | Metoject 20mg/0.4ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 40293 | CPRD_product_code | Metoject 25mg/0.5ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40301 | CPRD_product_code | Methotrexate 7.5mg/0.15ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40328 | CPRD_product_code | Methotrexate 25mg/0.5ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 40356 | CPRD_product_code | Metoject 10mg/0.2ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 40371 | CPRD_product_code | Methotrexate 10mg/0.2ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 41086 | CPRD_product_code | Methotrexate 5g/50ml solution for infusion vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 41104 | CPRD_product_code | Methotrexate 2.5mg tablets (Wockhardt UK Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 41585 | CPRD_product_code | Methotrexate sodium 2.5mg Tablet (Wyeth Pharmaceuticals) | drug | res25: M3_methotrexate | Methotrexate | ||
| 44908 | CPRD_product_code | Methotrexate 30mg/0.6ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 45165 | CPRD_product_code | Methotrexate 20mg/1ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 45558 | CPRD_product_code | Methotrexate 25mg/1.25ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 46039 | CPRD_product_code | Methotrexate 30mg/1.5ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 46098 | CPRD_product_code | Metoject 12.5mg/0.25ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 46129 | CPRD_product_code | Methotrexate 22.5mg/0.45ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 46152 | CPRD_product_code | Methotrexate 12.5mg/0.25ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 46156 | CPRD_product_code | Methotrexate 17.5mg/0.35ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate | ||
| 46197 | CPRD_product_code | Metoject 22.5mg/0.45ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 46265 | CPRD_product_code | Metoject 17.5mg/0.35ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 46407 | CPRD_product_code | Methotrexate 1g/40ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 49547 | CPRD_product_code | Methotrexate 5g/200ml solution for infusion vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 49951 | CPRD_product_code | Methotrexate 2.5mg tablets (Sandoz Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 50950 | CPRD_product_code | Metoject 30mg/0.6ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate | ||
| 51120 | CPRD_product_code | Methotrexate 2.5mg tablets (Alliance Healthcare (Distribution) Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 51321 | CPRD_product_code | Methotrexate 50mg/2ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 51667 | CPRD_product_code | Methotrexate 200mg/8ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 52606 | CPRD_product_code | Methotrexate 2.5mg tablets (Sigma Pharmaceuticals Plc) | drug | res25: M3_methotrexate | Methotrexate | ||
| 53385 | CPRD_product_code | Methotrexate 2.5mg tablets (Waymade Healthcare Plc) | drug | res25: M3_methotrexate | Methotrexate | ||
| 53696 | CPRD_product_code | Methotrexate 50mg/2ml solution for injection vials (A A H Pharmaceuticals Ltd) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 56037 | CPRD_product_code | Methotrexate 2.5mg tablets (A A H Pharmaceuticals Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 57103 | CPRD_product_code | Metoject 27.5mg/0.55ml solution for injection pre-filled syringes (medac UK) | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 57174 | CPRD_product_code | Methotrexate 10mg tablets (Waymade Healthcare Plc) | drug | res25: M3_methotrexate | Methotrexate | ||
| 57441 | CPRD_product_code | Methotrexate 10mg tablets (A A H Pharmaceuticals Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 58303 | CPRD_product_code | Methotrexate 2.5mg tablets (Orion Pharma (UK) Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 58885 | CPRD_product_code | Methotrexate 10mg tablets (Sigma Pharmaceuticals Plc) | drug | res25: M3_methotrexate | Methotrexate | ||
| 59538 | CPRD_product_code | Methotrexate 10mg tablets (Teva UK Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 59685 | CPRD_product_code | Methotrexate 2.5mg tablets (Teva UK Ltd) | drug | res25: M3_methotrexate | Methotrexate | ||
| 59723 | CPRD_product_code | Methotrexate 7.5mg/5ml oral solution | drug | res25: M3_methotrexate | Methotrexate | ||
| 7336 | CPRD_product_code | Methotrexate 12.5mg/0.5ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 7337 | CPRD_product_code | Methotrexate 10mg/0.4ml solution for injection pre-filled syringes | drug | res25: M3_methotrexate | Methotrexate sodium | ||
| 823 | CPRD_product_code | Methotrexate 2.5mg tablets | drug | res25: M3_methotrexate | Methotrexate | ||
| 8327 | CPRD_product_code | Methotrexate 50mg/3ml Injection | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 8583 | CPRD_product_code | Methotrexate 25mg/ml Injection | drug | res25: M3_methotrexate | Methotrexate Sodium | ||
| 877 | CPRD_product_code | Methotrexate 10mg tablets | drug | res25: M3_methotrexate | Methotrexate | ||
| 9528 | CPRD_product_code | Methotrexate 5mg/2ml solution for injection vials | drug | res25: M3_methotrexate | Methotrexate sodium |
Please log in to leave a comment.
Code list links:
ClinicalCodes is a project at the University of Manchester Institute of Population Health
The ClinicalCodes project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR)