Challenges of using primary care electronic medical records in the UK to study medications in pregnancy
Challenges of using primary care electronic medical records in the UK to study medications in pregnancy
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DOI：
10.1002/pds.3472
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发表时间：
2013-09-01
影响因子：
2.6
通讯作者：
Hernandez-Diaz, Sonia
中科院分区：
文献类型：
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作者：
Cea-Soriano, Lucia;Garcia Rodriguez, Luis A.;Hernandez-Diaz, Sonia
目的 本文旨在评估英国初级保健医生在怀孕期间开出的药物处方。 方法 我们采用三个连续周期的算法，在 1996 年至 2010 年间，通过搜索 Read 的三个连续周期的算法，确定了 1996 年至 2010 年间加入健康改善网络 (THIN) 的 13-49 岁女性的完全妊娠和流产（异位妊娠、流产、终止妊娠和死产）。 按层次顺序排列的代码组： (1) 概念指标； （二）分娩或者流产； (3) 其他暗示怀孕的代码。通过家庭身份证号码和出生日期将完成的妊娠与活产婴儿联系起来。计算了妊娠前三个月的特定药物处方以及过去十年的时间趋势。 结果 总共识别出 191000 例妊娠，其中完成妊娠 148544 例，流产 42456 例（22.2%）（宫外孕、流产、流产和死产）。在已完成的妊娠中，有 131670 例（88.6%）与后代成功连接。最常用的处方药是抗生素、抗真菌药、哮喘/过敏药物和镇痛药。从 1996 年到 2010 年，在妊娠前三个月至少服用一种处方药物的完成妊娠比例有所增加，其中包括抗抑郁药（1.8% 至 4.2%）、甲状腺激素（0.7% 至 1.6%）和阿片类药物（1.5% 至 2.6%）等药物。的 过去十年。我们讨论了当考虑到重要挑战时，THIN 如何成为研究妊娠期间特定疗法的有前途的资源。版权所有 (c) 2013 John Wiley & Sons, Ltd.
Purpose This paper aimed to assess the prescription of medications during pregnancy by primary care physicians in the UK.Methods We identified both completed pregnancies and pregnancies losses (ectopic pregnancies, miscarriages, terminations, and stillbirths) in women aged 13-49years enrolled in The Health Improvement Network (THIN) between 1996 and 2010 following an algorithm with three sequential cycles that searched for Read Code groups in hierarchical order: (1) indicators of conception; (2) delivery or pregnancy loss; and (3) other codes suggestive of pregnancy. Completed pregnancies were linked to liveborn infants by means of the family identification number and date of birth. Prescription of specific drugs during the first trimester and time trends during the last decade were calculated.Results A total of 191000 pregnancies were identified, including 148544 completed pregnancies and 42456 (22.2%) pregnancies losses (ectopic pregnancies, miscarriages, terminations, and stillbirths). Of the completed pregnancies, 131670 (88.6%) were successfully linked with the offspring. The most commonly prescribed drugs were antibiotics, antimycotics, asthma/allergy medications, and analgesics. From 1996 to 2010, the proportion of completed pregnancies with at least one prescription during the first trimester increased for antidepressants (1.8% to 4.2%), thyroid hormones (0.7% to 1.6%), and opiods (1.5% to 2.6%), among other drugs.Conclusion In conclusion, the prescription of several medications by primary care physicians during the first trimester of pregnancy has risen in the UK during the last decade. We discuss how, when important challenges are considered, THIN may be a promising resource to study specific therapies during pregnancy. Copyright (c) 2013 John Wiley & Sons, Ltd.