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Prescribing of neuraminidase inhibitors for influenza in UK primary care since the 2009 pandemic.

ABSTRACT: We determined prescribing rates of neuraminidase inhibitors (NIs) for influenza in UK primary care since 2009 in relation to national prescribing guidelines. All NI prescriptions issued during the influenza seasons between October 2010 and May 2013 were extracted from The Health Improvement Network (THIN), a large UK primary-care database. We calculated NI prescribing rates per 100,000 person-weeks (pw) by age group, sex, deprivation level, influenza season and presence of chronic conditions with 95% confidence intervals (CIs), and used negative binomial regression models to determine the independent association between these variables and NI prescribing. NI prescribing was rare. The prescribing rate was 1·7/100,000 pw (95% CI 1·7-1·8) during influenza-active periods, and 0·1/100,000 (95% CI 0·1-0·1) during non-active periods. Prescribing rates were highest in 25- to 44-year-olds in 2010/2011 and in persons aged ?85 years in 2011/2012 and 2012/2013. Individuals with chronic conditions had significantly higher prescribing rates than persons without (rate ratio 2·62, 95% CI 2·27-3·03). GPs are more likely to prescribe NIs to high-risk individuals and during influenza active periods, as per national guidelines. We could not assess the proportion of patients with influenza-like illness who were prescribed an NI.

SUBMITTER: Hardelid P

PROVIDER: S-EPMC4894469 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Prescribing of neuraminidase inhibitors for influenza in UK primary care since the 2009 pandemic.

Hardelid P P Rait G G Gilbert R R Petersen I I

Epidemiology and infection 20150914 4

We determined prescribing rates of neuraminidase inhibitors (NIs) for influenza in UK primary care since 2009 in relation to national prescribing guidelines. All NI prescriptions issued during the influenza seasons between October 2010 and May 2013 were extracted from The Health Improvement Network (THIN), a large UK primary-care database. We calculated NI prescribing rates per 100,000 person-weeks (pw) by age group, sex, deprivation level, influenza season and presence of chronic conditions wit ...[more]

PMID: 26364671

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Project description:ObjectiveTo examine the recorded indication for antipsychotic prescriptions in UK primary care.DesignCohort study.SettingPrimary care.ParticipantsIndividuals prescribed antipsychotics between 2007 and 2011.MeasuresThe proportion of individuals prescribed antipsychotics with a diagnosis of (1) psychosis and bipolar disorder, (2) other diagnoses including depression, anxiety and dementia and (3) none of these diagnoses.ResultsWe identified 47,724 individuals prescribed antipsychotic agents. 13,941 received first-generation agents and 27,966 received second-generation agents. The rates of prescribing were higher in females (incidence rate ratio (IRR) 1.092 (95% CI 1.088 to 1.095), older people (80+ vs 40-49; IRR 2.234 (2.222 to 2.246)) and in those from the most deprived areas (most deprived vs least deprived IRR 3.487 (3.567 to 3.606). Of those receiving first-generation antipsychotics, less than 50% had a diagnosis of psychosis/bipolar disorder. For the second-generation agents, the numbers ranged from 4824 (36%) for quetiapine to 7094 (62%) for olanzapine. In patients without psychosis/bipolar disorder, common diagnoses included anxiety, depression, dementia, sleep and personality disorders. For example, in risperidone users, 14% had an anxiety code, 22% depression, 12% dementia, 11% sleep disorder and 4% personality disorder. The median daily doses and duration of treatment were greater in those with schizophrenia (eg, risperidone median daily dose 4?mg; IQR 2-6: median duration 1.2?years) than in those with non-psychotic/bipolar disorders such as depression or anxiety (eg, risperidone 1?mg; IQR 1-2: 0.6?years). A relatively large proportion (between 6% and 17%) of people receiving individual antipsychotics had none of the diagnoses stated above.ConclusionsIn UK primary care, a large proportion of people prescribed antipsychotics have no record of psychotic or bipolar disorder. They are often older people with conditions including dementia, non-psychotic depression, anxiety and sleep disorders.

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Prescribing of neuraminidase inhibitors for influenza in UK primary care since the 2009 pandemic.

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Prescribing of neuraminidase inhibitors for influenza in UK primary care since the 2009 pandemic.

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