Changes in English medication safety indicators throughout the COVID-19 pandemic: a federated analysis of 57 million patients' primary care records in situ using OpenSAFELY
Changes in English medication safety indicators throughout the COVID-19 pandemic: a federated analysis of 57 million patients' primary care records in situ using OpenSAFELY
复制标题
COVID-19 大流行期间英国用药安全指标的变化：使用 OpenSAFELY 对 5700 万患者的初级保健记录进行联合分析
DOI：
10.1101/2022.05.05.22273234
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
B. Mackenna
中科院分区：
文献类型：
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作者：
Louis Fisher;L. Hopcroft;S. Rodgers;James Barrett;Kerry Oliver;Anthony J Avery;David Evans;Helen J. Curtis;R. Croker;O. Macdonald;Jessica Morley;A. Mehrkar;S. Bacon;S. Davy;I. Dillingham;David Evans;G. Hickman;P. Inglesby;C. Morton;Becky Smith;Tom Ward;W. Hulme;A. Green;J. Massey;Alex J. Walker;Chris Bates;J. Cockburn;John Parry;F. Hester;Sam Harper;S. O’Hanlon;A. Eavis;R. Jarvis;D. Avramov;P. Griffiths;A. Fowles;N. Parkes;B. Goldacre;B. Mackenna
目的：使用PINCER处方指标描述COVID-19大流行对安全处方的影响;使用GP数据在全国范围内实施复杂的处方指标。设计：基于人群的队列研究，使用OpenSAFELY平台获得英国NHS的批准。设置：电子健康记录数据来自5680万NHS患者的全科医疗记录。参会人员：所有NHS患者在2019年9月至2021年9月期间使用TPP或EMIS计算机系统在全科医生诊所登记，并记录为至少一种潜在危险PINCER指标的风险。主要结果指标：2019年9月至2021年9月期间13项PINCER指标合规性的月度趋势和实践间变化。结果：这些指标在OpenSAFELY的GP数据中成功实施。有害处方在COVID-19疫情期间基本保持不变，仅在实现PINCER指标方面略有下降。一些药物的血液检测监测出现短暂延迟，特别是ACE抑制剂。所有指标于2021年9月均大幅回升。我们确定了1，813，058名患者至少有一次危险处方事件的风险。结论：在COVID-19大流行期间，在广泛评估的各种安全处方措施中保持了良好的表现。
Objective: To describe the impact of the COVID-19 pandemic on safe prescribing, using the PINCER prescribing indicators; to implement complex prescribing indicators at national scale using GP data. Design: Population based cohort study, with the approval of NHS England using the OpenSAFELY platform. Setting: Electronic health record data from 56.8 million NHS patients' general practice records. Participants: All NHS patients registered at a GP practice using TPP or EMIS computer systems and recorded as at risk of at least one potentially hazardous PINCER indicator between September 2019 and September 2021. Main outcome measure: Monthly trends and between-practice variation for compliance with 13 PINCER measures between September 2019 and September 2021. Results: The indicators were successfully implemented across GP data in OpenSAFELY. Hazardous prescribing remained largely unchanged during the COVID-19 pandemic, with only small reductions in achievement of the PINCER indicators. There were transient delays in blood test monitoring for some medications, particularly ACE inhibitors. All indicators exhibited substantial recovery by September 2021. We identified 1,813,058 patients at risk of at least one hazardous prescribing event. Conclusion: Good performance was maintained during the COVID-19 pandemic across a diverse range of widely evaluated measures of safe prescribing.