ClinicalCodes.org
An online clinical codes repository to improve validity and reproducibility of medical database research
Research article:
Clinical management following self-harm in a UK-wide primary care cohort
Reference:
Matthew J Carr, Darren M Ashcroft, Evan Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb(2016) Clinical management following self-harm in a UK-wide primary care cohort. Journal of Affective Disorders, doi:
- Link to article
- Abstract
- Background: Little is known about the clinical management of patients in primary care following self-harm. Methods: A descriptive cohort study using data from 684 UK general practices that contributed to the Clinical Practice Research Datalink (CPRD) during 2001-2013. We identified 49,970 patients with a self-harm episode, 41,500 of whom had one complete year of follow-up. Results: Among those with complete follow-up, 26,065 (62.8%, 62.3-63.3) were prescribed psychotropic medication and 6,318 (15.2%, 14.9-15.6) were referred to mental health services; 4,105 (9.9%, CI 9.6-10.2) were medicated without an antecedent psychiatric diagnosis or referral, and 4,506 (10.9%, CI 10.6-11.2) had a diagnosis but were not subsequently medicated or referred. Patients registered at practices in the most deprived localities were 27.1% (CI 21.5-32.2) less likely to be referred than those in the least deprived. Despite a specifically flagged NICE ‘Do not do’ recommendation in 2011 against prescribing tricyclic antidepressants following self-harm because of their potentially lethal toxicity in overdose, 8.8% (CI 7.8-9.8) of individuals were issued a prescription in the subsequent year. The percentage prescribed Citalopram, an SSRI antidepressant with higher toxicity in overdose, fell sharply during 2012/2013 in the aftermath of a Medicines and Healthcare products Regulatory Agency (MHRA) safety alert issued in 2011. Conclusions: A relatively small percentage of these vulnerable patients are referred to mental health services, and reduced likelihood of referral in more deprived localities reflects a marked health inequality. National clinical guidelines have not yet been effective in reducing rates of tricyclic antidepressant prescribing for this high-risk group.
- Author for correspondence
- Matthew J Carr
- Email for correspondence
- matthew.carr@manchester.ac.uk
Code list: res36: SSRI ADDs
120 codes in list
| Code | Coding system | Description | Entity type | List name | |||
|---|---|---|---|---|---|---|---|
| 03837020 | Multilex | Prozac 20mg capsules (Lexon (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 03985020 | Multilex | Citalopram 20mg tablets (Alliance Healthcare (Distribution) Ltd) | drug | res36: SSRI ADDs | |||
| 03997020 | Multilex | Citalopram 20mg tablets (Bristol Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 04003020 | Multilex | Citalopram 10mg tablets (Kent Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 04004020 | Multilex | Citalopram 10mg tablets (Alliance Healthcare (Distribution) Ltd) | drug | res36: SSRI ADDs | |||
| 04007020 | Multilex | Citalopram 10mg tablets (Arrow Generics Ltd) | drug | res36: SSRI ADDs | |||
| 04011020 | Multilex | Citalopram 10mg tablets (Bristol Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 20738020 | Multilex | Sertraline 100mg/5ml oral suspension | drug | res36: SSRI ADDs | |||
| 33816020 | Multilex | Sertraline 25mg/5ml oral suspension | drug | res36: SSRI ADDs | |||
| 38526020 | Multilex | Citalopram 20mg tablets (DE Pharmaceuticals) | drug | res36: SSRI ADDs | |||
| 49680020 | Multilex | Felicium 20mg capsules (Opus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 53823020 | Multilex | Escitalopram 20mg tablets | drug | res36: SSRI ADDs | |||
| 55602020 | Multilex | Cipralex 20mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 60735020 | Multilex | Fluvoxamine 100mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res36: SSRI ADDs | |||
| 61084020 | Multilex | Fluoxetine 20mg capsules (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 61167020 | Multilex | Fluoxetine 20mg capsules (IVAX Pharmaceuticals UK Ltd) | drug | res36: SSRI ADDs | |||
| 61319020 | Multilex | Fluoxetine 20mg capsules (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 61387020 | Multilex | Fluoxetine 20mg capsules (Sandoz Ltd) | drug | res36: SSRI ADDs | |||
| 61409020 | Multilex | Fluoxetine 20mg capsules (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 61420020 | Multilex | Fluoxetine 20mg capsules (Niche Generics Ltd) | drug | res36: SSRI ADDs | |||
| 61439020 | Multilex | Fluoxetine 20mg capsules (Wockhardt UK Ltd) | drug | res36: SSRI ADDs | |||
| 61452020 | Multilex | Fluoxetine 20mg capsules (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 61455020 | Multilex | Fluoxetine 20mg capsules (Genus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 61616020 | Multilex | Fluoxetine 20mg capsules (Zentiva) | drug | res36: SSRI ADDs | |||
| 62069020 | Multilex | Fluvoxamine 50mg tablets | drug | res36: SSRI ADDs | |||
| 62070020 | Multilex | Fluvoxamine 100mg tablets | drug | res36: SSRI ADDs | |||
| 62073020 | Multilex | Faverin 50mg tablets (Abbott Healthcare Products Ltd) | drug | res36: SSRI ADDs | |||
| 62074020 | Multilex | Faverin 100mg tablets (Abbott Healthcare Products Ltd) | drug | res36: SSRI ADDs | |||
| 62693020 | Multilex | Fluvoxamine 100mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 62975020 | Multilex | Fluoxetine 20mg capsules (Fannin UK Ltd) | drug | res36: SSRI ADDs | |||
| 63016020 | Multilex | Fluoxetine 20mg capsules (Ranbaxy (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 63703020 | Multilex | Paroxetine 20mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res36: SSRI ADDs | |||
| 64692020 | Multilex | Fluoxetine 20mg/5ml oral solution (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 64717020 | Multilex | Fluoxetine 20mg/5ml oral solution (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 65125020 | Multilex | Citalopram 10mg tablets (Sandoz Ltd) | drug | res36: SSRI ADDs | |||
| 65128020 | Multilex | Citalopram 20mg tablets (Sandoz Ltd) | drug | res36: SSRI ADDs | |||
| 65131020 | Multilex | Citalopram 40mg tablets (Sandoz Ltd) | drug | res36: SSRI ADDs | |||
| 65254020 | Multilex | Citalopram 10mg Tablet (Neo Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 65257020 | Multilex | Citalopram 20mg Tablet (Neo Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 65262020 | Multilex | Citalopram 40mg Tablet (Neo Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 65376020 | Multilex | Citalopram 10mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 65381020 | Multilex | Citalopram 20mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 65386020 | Multilex | Citalopram 40mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 65464020 | Multilex | Fluoxetine 60mg capsules (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 65578020 | Multilex | Paroxetine 20mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 66129020 | Multilex | Fluoxetine 20mg/5ml oral solution (IVAX Pharmaceuticals UK Ltd) | drug | res36: SSRI ADDs | |||
| 66149020 | Multilex | Citalopram 10mg tablets (Zentiva) | drug | res36: SSRI ADDs | |||
| 66152020 | Multilex | Citalopram 20mg tablets (Zentiva) | drug | res36: SSRI ADDs | |||
| 66160020 | Multilex | Citalopram 40mg tablets (Zentiva) | drug | res36: SSRI ADDs | |||
| 66244020 | Multilex | Fluvoxamine 100mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 66273020 | Multilex | Fluoxetine 20mg capsules (Tillomed Laboratories Ltd) | drug | res36: SSRI ADDs | |||
| 66399020 | Multilex | Paroxetine 20mg tablets (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 66451020 | Multilex | Citalopram 10mg tablets (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 66454020 | Multilex | Citalopram 20mg tablets (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 66459020 | Multilex | Citalopram 40mg tablets (Generics (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 66464020 | Multilex | Paroxetine 20mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 66680020 | Multilex | Citalopram 10mg tablets (Niche Generics Ltd) | drug | res36: SSRI ADDs | |||
| 66685020 | Multilex | Citalopram 20mg tablets (Niche Generics Ltd) | drug | res36: SSRI ADDs | |||
| 66688020 | Multilex | Citalopram 40mg tablets (Niche Generics Ltd) | drug | res36: SSRI ADDs | |||
| 67575020 | Multilex | Paroxetine 30mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 67650020 | Multilex | Paroxetine 30mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 67890020 | Multilex | Citalopram 10mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 67893020 | Multilex | Citalopram 20mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 67898020 | Multilex | Citalopram 40mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 68042020 | Multilex | Citalopram 10mg tablets (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 68045020 | Multilex | Citalopram 20mg tablets (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 68049020 | Multilex | Citalopram 40mg tablets (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 69506020 | Multilex | Prozac 20mg capsules (Eli Lilly and Company Ltd) | drug | res36: SSRI ADDs | |||
| 69507020 | Multilex | Prozac 20mg/5ml liquid (Eli Lilly and Company Ltd) | drug | res36: SSRI ADDs | |||
| 69508020 | Multilex | Prozac 60mg capsules (Eli Lilly and Company Ltd) | drug | res36: SSRI ADDs | |||
| 69654020 | Multilex | Fluoxetine 20mg capsules | drug | res36: SSRI ADDs | |||
| 69655020 | Multilex | Fluoxetine 20mg/5ml oral solution | drug | res36: SSRI ADDs | |||
| 69656020 | Multilex | Fluoxetine 60mg capsules | drug | res36: SSRI ADDs | |||
| 69754020 | Multilex | Paroxetine 20mg tablets (Genus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 71214020 | Multilex | Citalopram 10mg tablets (PLIVA Pharma Ltd) | drug | res36: SSRI ADDs | |||
| 71225020 | Multilex | Citalopram 10mg tablets (IVAX Pharmaceuticals UK Ltd) | drug | res36: SSRI ADDs | |||
| 71373020 | Multilex | Citalopram 10mg tablets (Almus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 71376020 | Multilex | Citalopram 20mg tablets (Almus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 71725020 | Multilex | Sertraline 50mg tablets (A A H Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 72034020 | Multilex | Sertraline 50mg tablets (Actavis UK Ltd) | drug | res36: SSRI ADDs | |||
| 72095020 | Multilex | Sertraline 100mg tablets (Teva UK Ltd) | drug | res36: SSRI ADDs | |||
| 72932020 | Multilex | Paroxetine 20mg tablets | drug | res36: SSRI ADDs | |||
| 72933020 | Multilex | Paroxetine 30mg tablets | drug | res36: SSRI ADDs | |||
| 72934020 | Multilex | Paroxetine 10mg/5ml oral suspension sugar free | drug | res36: SSRI ADDs | |||
| 72937020 | Multilex | Seroxat 20mg tablets (GlaxoSmithKline UK Ltd) | drug | res36: SSRI ADDs | |||
| 72938020 | Multilex | Seroxat 30mg tablets (GlaxoSmithKline UK Ltd) | drug | res36: SSRI ADDs | |||
| 72939020 | Multilex | Seroxat 20mg/10ml liquid (GlaxoSmithKline UK Ltd) | drug | res36: SSRI ADDs | |||
| 74046020 | Multilex | Lustral 50mg tablets (Pfizer Ltd) | drug | res36: SSRI ADDs | |||
| 74047020 | Multilex | Lustral 100mg tablets (Pfizer Ltd) | drug | res36: SSRI ADDs | |||
| 74050020 | Multilex | Sertraline 50mg tablets | drug | res36: SSRI ADDs | |||
| 74051020 | Multilex | Sertraline 100mg tablets | drug | res36: SSRI ADDs | |||
| 74425020 | Multilex | Fluoxetine 20mg Capsule (Milpharm Ltd) | drug | res36: SSRI ADDs | |||
| 75620020 | Multilex | Sertraline 50mg tablets (Almus Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 77306020 | Multilex | Citalopram 40mg/ml oral drops sugar free | drug | res36: SSRI ADDs | |||
| 77312020 | Multilex | Cipramil 40mg/ml drops (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 78768020 | Multilex | Escitalopram 10mg tablets | drug | res36: SSRI ADDs | |||
| 79420020 | Multilex | Cipramil 20mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 79421020 | Multilex | Cipramil 10mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 79422020 | Multilex | Cipramil 40mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 79462020 | Multilex | Citalopram 20mg tablets | drug | res36: SSRI ADDs | |||
| 79463020 | Multilex | Citalopram 10mg tablets | drug | res36: SSRI ADDs | |||
| 79464020 | Multilex | Citalopram 40mg tablets | drug | res36: SSRI ADDs | |||
| 80679020 | Multilex | Oxactin 20mg capsules (Discovery Pharmaceuticals Ltd) | drug | res36: SSRI ADDs | |||
| 80777020 | Multilex | Prozit 20mg/5ml oral solution (Pinewood Healthcare) | drug | res36: SSRI ADDs | |||
| 82055020 | Multilex | Ranflutin 20mg capsules (Ranbaxy (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 86222020 | Multilex | Cipralex 10mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 87524020 | Multilex | Escitalopram 5mg tablets | drug | res36: SSRI ADDs | |||
| 87526020 | Multilex | Cipralex 5mg tablets (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 88346020 | Multilex | Paxoran 10mg Tablet (Ranbaxy (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 88348020 | Multilex | Paxoran 20mg Tablet (Ranbaxy (UK) Ltd) | drug | res36: SSRI ADDs | |||
| 90497020 | Multilex | Sertraline 50mg/5ml oral suspension | drug | res36: SSRI ADDs | |||
| 90871020 | Multilex | Escitalopram 10mg/ml oral drops sugar free | drug | res36: SSRI ADDs | |||
| 90873020 | Multilex | Cipralex 10mg/ml oral drops (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 92043020 | Multilex | Paroxetine 10mg tablets | drug | res36: SSRI ADDs | |||
| 93187020 | Multilex | Seroxat 10mg tablets (GlaxoSmithKline UK Ltd) | drug | res36: SSRI ADDs | |||
| 93918020 | Multilex | Prozep 20mg/5ml oral solution (Chemidex Pharma Ltd) | drug | res36: SSRI ADDs | |||
| 93984020 | Multilex | Fluoxetine 20mg/5ml oral solution sugar free | drug | res36: SSRI ADDs | |||
| 97169020 | Multilex | Escitalopram 20mg/ml oral drops sugar free | drug | res36: SSRI ADDs | |||
| 97171020 | Multilex | Cipralex 20mg/ml oral drops (Lundbeck Ltd) | drug | res36: SSRI ADDs | |||
| 98001020 | Multilex | Fluoxetine 10mg tablets | drug | res36: SSRI ADDs |
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