Publications by authors named "Jonathan Cockburn"
Article Synopsis
- The COVID-19 pandemic negatively impacted cardiovascular disease management in England, particularly affecting blood pressure screening and hypertension management.
- A study analyzed data from 25.2 million NHS patients, showing a decline in blood pressure screening from 90% in March 2019 to 85% in March 2023, while hypertension prevalence remained stable at about 15%.
- Treatment percentages for hypertension also dropped significantly during the pandemic, with patients aged ≤79 years treated to target falling from 71% to 47% and those aged ≥80 years from 85% to 58% before showing signs of recovery.
Article Synopsis
- * In the OpenSAFELY-TPP database, 78.2% of patients had their ethnicity recorded in primary care as of January 2022, with higher rates in women and those with serious health conditions.
- * The primary care ethnicity data closely matched the 2021 UK census data, with a high consistency found among patients with multiple ethnicity records, particularly indicating issues with classification for those recorded as "Other."
Article Synopsis
- - The study examines how the Covid-19 pandemic influenced the rates of group A streptococcal infections and related antibiotic prescriptions in primary care practices across England from January 2018 to March 2023.
- - Significant findings show that infections and antibiotic prescriptions peaked in December 2022, surpassing levels seen during the 2017-18 season, with notable increases in rates for sore throat, scarlet fever, and invasive infections.
- - The research highlights a concerning trend, reporting that the rate ratios for infections and prescriptions in the 2022-23 season were considerably higher compared to the pre-pandemic period, suggesting lasting impacts from the pandemic on public health.
Aims: The COVID-19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease-modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID-19 pandemic.
Methods: A population-based cohort study was conducted using the OpenSAFELY platform to access electronic health record data from 24.
Aims: The COVID-19 pandemic caused significant disruption to routine activity in primary care. Medication reviews are an important primary care activity ensuring safety and appropriateness of prescribing. A disruption could have significant negative implications for patient care.
View Article and Find Full Text PDFBackground: Timely evidence of the comparative effectiveness between COVID-19 therapies in real-world settings is needed to inform clinical care. This study aimed to compare the effectiveness of nirmatrelvir/ritonavir versus sotrovimab and molnupiravir in preventing severe COVID-19 outcomes in non-hospitalised high-risk COVID-19 adult patients during Omicron waves.
Methods: With the approval of NHS England, we conducted a real-world cohort study using the OpenSAFELY-TPP platform.
Background: The COVID-19 pandemic affected how care was delivered to vulnerable patients, such as those with dementia or learning disability.
Objective: To explore whether this affected antipsychotic prescribing in at-risk populations.
Methods: With the approval of NHS England, we completed a retrospective cohort study, using the OpenSAFELY platform to explore primary care data of 59 million patients.
Article Synopsis
- - The COVID-19 pandemic significantly disrupted NHS primary care services, leading to the creation of the OpenSAFELY Service Restoration Observatory (SRO) to track clinical activity trends throughout this period.
- - An open-source data management framework was developed to analyze electronic health records from 48 million adults, focusing on key measures like blood pressure monitoring and asthma reviews from January 2019 to December 2021.
- - While most clinical activities showed signs of recovery by April 2021, some measures like medication and blood pressure reviews continued to experience notable reductions, indicating lasting impacts from the pandemic.
The coronavirus disease 2019 (COVID-19) vaccination programme in England was extended to include all adolescents and children by April 2022. The aim of this paper is to describe trends and variation in vaccine coverage in different clinical and demographic groups amongst adolescents and children in England by August 2022. With the approval of NHS England, a cohort study was conducted of 3.
View Article and Find Full Text PDFObjective: To implement complex, PINCER (pharmacist led information technology intervention) prescribing indicators, on a national scale with general practice data to describe the impact of the covid-19 pandemic on safe prescribing.
Design: Population based, retrospective cohort study using federated analytics.
Setting: Electronic general practice health record data from 56.
Article Synopsis
- The study investigated how different demographic and clinical groups experienced varying mortality risks related to COVID-19 across five pandemic waves in England, using data from the OpenSAFELY platform.
- A total of nearly 19 million adults were analyzed across each wave, with significant trends showing a decrease in crude COVID-19-related death rates from the first wave to the fifth.
- The highest standardized death rates were found among older adults and those with certain health conditions, such as advanced kidney disease or dementia, especially in the first wave of the pandemic.
Article Synopsis
- The study aimed to determine patient eligibility and describe the coverage of antiviral drugs and neutralising monoclonal antibodies (nMAB) as treatments for COVID-19 in community settings in England.
- A retrospective analysis was conducted on data from 23.4 million people, focusing on outpatients with COVID-19 who were at high risk for severe outcomes between December 2021 and April 2022.
- Out of 93,870 high-risk patients identified, only 19,040 (20%) received treatment, with variations in treatment rates based on factors like age, ethnic background, risk group, and NHS region.
Objective: To characterise factors associated with COVID-19 vaccine uptake among people with kidney disease in England.
Design: Retrospective cohort study using the OpenSAFELY-TPP platform, performed with the approval of NHS England.
Setting: Individual-level routine clinical data from 24 million people across GPs in England using TPP software.
Objective: To compare the effectiveness of sotrovimab (a neutralising monoclonal antibody) with molnupiravir (an antiviral) in preventing severe outcomes of covid-19 in adult patients infected with SARS-CoV-2 in the community and at high risk of severe outcomes from covid-19.
Design: Observational cohort study with the OpenSAFELY platform.
Setting: With the approval of NHS England, a real world cohort study was conducted with the OpenSAFELY-TPP platform (a secure, transparent, open source software platform for analysis of NHS electronic health records), and patient level electronic health record data were obtained from 24 million people registered with a general practice in England that uses TPP software.
BackgroundPriority patients in England were offered COVID-19 vaccination by mid-April 2021. Codes in clinical record systems can denote the vaccine being declined.AimWe describe records of COVID-19 vaccines being declined, according to clinical and demographic factors.
View Article and Find Full Text PDFSince its inception in March 2020, data from the OpenSAFELY-TPP electronic health record platform has been used for more than 20 studies relating to the global COVID-19 emergency. OpenSAFELY-TPP data is derived from practices in England using SystmOne software, and has been used for the majority of these studies. We set out to investigate the representativeness of OpenSAFELY-TPP data by comparing it to national population estimates.
View Article and Find Full Text PDFObjective: To compare the effectiveness of the BNT162b2 mRNA (Pfizer-BioNTech) and the ChAdOx1 (Oxford-AstraZeneca) covid-19 vaccines against infection and covid-19 disease in health and social care workers.
Design: Cohort study, emulating a comparative effectiveness trial, on behalf of NHS England.
Setting: Linked primary care, hospital, and covid-19 surveillance records available within the OpenSAFELY-TPP research platform, covering a period when the SARS-CoV-2 Alpha variant was dominant.
Background: While the vaccines against COVID-19 are highly effective, COVID-19 vaccine breakthrough is possible despite being fully vaccinated. With SARS-CoV-2 variants still circulating, describing the characteristics of individuals who have experienced COVID-19 vaccine breakthroughs could be hugely important in helping to determine who may be at greatest risk.
Methods: With the approval of NHS England, we conducted a retrospective cohort study using routine clinical data from the OpenSAFELY-TPP database of fully vaccinated individuals, linked to secondary care and death registry data and described the characteristics of those experiencing COVID-19 vaccine breakthroughs.
Introduction: We investigated the potential association of COVID-19 vaccination with three acute neurological events: Guillain-Barré syndrome (GBS), transverse myelitis and Bell's palsy.
Methods: With the approval of NHS England we analysed primary care data from >17 million patients in England linked to emergency care, hospital admission and mortality records in the OpenSAFELY platform. Separately for each vaccine brand, we used a self-controlled case series design to estimate the incidence rate ratio for each outcome in the period following vaccination (4-42 days for GBS, 4-28 days for transverse myelitis and Bell's palsy) compared to a within-person baseline, using conditional Poisson regression.
Background: The risk of severe COVID-19 outcomes in people with immune-mediated inflammatory diseases and on immune-modifying drugs might not be fully mediated by comorbidities and might vary by factors such as ethnicity. We aimed to assess the risk of severe COVID-19 in adults with immune-mediated inflammatory diseases and in those on immune-modifying therapies.
Methods: We did a cohort study, using OpenSAFELY (an analytics platform for electronic health records) and TPP (a software provider for general practitioners), analysing routinely collected primary care data linked to hospital admission, death, and previously unavailable hospital prescription data.
At the outset of the COVID-19 pandemic, there was no routine comprehensive hospital medicines data from the UK available to researchers. These records can be important for many analyses including the effect of certain medicines on the risk of severe COVID-19 outcomes. With the approval of NHS England, we set out to obtain data on one specific group of medicines, "high-cost drugs" (HCD) which are typically specialist medicines for the management of long-term conditions, prescribed by hospitals to patients.
View Article and Find Full Text PDFPatients surviving hospitalisation for COVID-19 are thought to be at high risk of cardiometabolic and pulmonary complications, but quantification of that risk is limited. We aimed to describe the overall burden of these complications in people after discharge from hospital with COVID-19. Working on behalf of NHS England, we used linked primary care records, death certificate and hospital data from the OpenSAFELY platform.
View Article and Find Full Text PDFBackground: Early evidence has shown that anticoagulant reduces the risk of thrombotic events in those infected with COVID-19. However, evidence of the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes is limited.
Aim: To investigate the association between OACs and COVID-19 outcomes in those with atrial fibrillation and a CHADS-VASc score of 2.
Comparison of methods for predicting COVID-19-related death in the general population using the OpenSAFELY platform.
Diagn Progn Res
February 2022
Background: Obtaining accurate estimates of the risk of COVID-19-related death in the general population is challenging in the context of changing levels of circulating infection.
Methods: We propose a modelling approach to predict 28-day COVID-19-related death which explicitly accounts for COVID-19 infection prevalence using a series of sub-studies from new landmark times incorporating time-updating proxy measures of COVID-19 infection prevalence. This was compared with an approach ignoring infection prevalence.