Prescribing of antipsychotics for people diagnosed with severe mental illness in UK primary care 2000-2019: 20-year investigation of who receives treatment, with which agents and at what doses.

Background: Contemporary data relating to antipsychotic prescribing in UK primary care for patients diagnosed with severe mental illness (SMI) are lacking.

Aims: To describe contemporary patterns of antipsychotic prescribing in UK primary care for patients diagnosed with SMI.

Method: Cohort study of patients with an SMI diagnosis (i.

Association between quetiapine use and self-harm outcomes among people with recorded personality disorder in UK primary care: A self-controlled case series analysis.

Background: Quetiapine is frequently prescribed to people with personality disorder diagnoses, but this is not supported by evidence or treatment guidelines.

Aims: To examine associations between periods of quetiapine prescribing and self-harm events in people with personality disorder.

Method: Self-controlled case series using linked primary care and hospital records covering the period 2007-2017.

Prescribing of antipsychotics among people with recorded personality disorder in primary care: a retrospective nationwide cohort study using The Health Improvement Network primary care database.

Objectives: To investigate the extent of antipsychotic prescribing to people with recorded personality disorder (PD) in UK primary care and factors associated with such prescribing.

Design: Retrospective cohort study.

Setting: General practices contributing to The Health Improvement Network UK-wide primary care database, 1 January 2000-31 December 2016.

Depression, depressive symptoms and treatments in women who have recently given birth: UK cohort study.

Objectives: To investigate how depression is recognised in the year after child birth and treatment given in clinical practice.

Design: Cohort study based on UK primary care electronic health records.

Setting: Primary care.

Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis.

Objective: To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs.

Design: Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083.

Effectiveness and cost-effectiveness of a cardiovascular risk prediction algorithm for people with severe mental illness (PRIMROSE).

Objectives: To determine the cost-effectiveness of two bespoke severe mental illness (SMI)-specific risk algorithms compared with standard risk algorithms for primary cardiovascular disease (CVD) prevention in those with SMI.

Setting: Primary care setting in the UK. The analysis was from the National Health Service perspective.

Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study.

Aims: Lack of financial incentive is a frequently cited barrier to alcohol screening in primary care. The Quality and Outcomes Framework (QOF) pay for performance scheme has reimbursed UK primary care practices for alcohol screening in people with schizophrenia since April 2011. This study aimed to determine the impact of financial incentives on alcohol screening by comparing rates of alcohol recording in people with versus those without schizophrenia between 2000 and 2013.

Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study.

Background: Screening for alcohol use disorders is an important priority in the healthcare of people with bipolar disorder, incentivised in UK primary care since 2011, through the Quality and Outcomes Framework (QOF). The extent of alcohol monitoring in primary care, and impact of QOF, is unknown. The aim was to examine recording of alcohol consumption in primary care.

Cardiovascular risk prediction models for people with severe mental illness: results from the prediction and management of cardiovascular risk in people with severe mental illnesses (PRIMROSE) research program.

Importance: People with severe mental illness (SMI), including schizophrenia and bipolar disorder, have excess rates of cardiovascular disease (CVD). Risk prediction models validated for the general population may not accurately estimate cardiovascular risk in this group.

Objective: To develop and validate a risk model exclusive to predicting CVD events in people with SMI incorporating established cardiovascular risk factors and additional variables.

Recording of severe mental illness in United Kingdom primary care, 2000-2010.

Background: There is increasing emphasis on primary care services for individuals with severe mental illnesses (SMI), including schizophrenia, bipolar disorder, and other non-organic psychotic disorders. However we lack information on how many people receive these different diagnoses in primary care. Primary care databases offer an opportunity to explore the recording of new SMI diagnoses in representative general practices.

Socio-demographic variation in chest pain incidence and subsequent coronary heart disease in primary care in the United Kingdom.

Background: We know little about socio-demographic differences in chest pain presenting to primary care and subsequent coronary heart disease (CHD) diagnosis.

Methods: We conducted a cohort study with 198,209 patients aged 30 years and over with a first episode of chest pain, using data from 339 general practices in The Health Improvement Network (THIN) primary care database during 1997-2007. We calculated incidence of chest pain and subsequent CHD by age, gender and quintiles of Townsend area deprivation score.

Are weekend handovers of adequate quality for the on-call general medical team?

Weekend handover is vital for patient safety--poor handover is a cause of avoidable adverse events. This study evaluated whether the quality of information handed over for patients requiring weekend review was adequate. Two external doctors imagined themselves as the doctor on-call and judged whether the handed-over information was adequate for each case.

Rising adiposity curbing decline in the incidence of myocardial infarction: 20-year follow-up of British men and women in the Whitehall II cohort.

Aims To estimate the contribution of risk factor trends to 20-year declines in myocardial infarction (MI) incidence in British men and women. Methods and results From 1985 to 2004, 6379 men and 3074 women in the Whitehall II cohort were followed for incident MI and risk factor trends. Over 20 years, the age-sex-adjusted hazard of MI fell by 74% (95% confidence interval 48-87%), corresponding to an average annual decline of 6.

Social class differences in secular trends in established coronary risk factors over 20 years: a cohort study of British men from 1978-80 to 1998-2000.

Background: Coronary heart disease (CHD) mortality in the UK since the late 1970s has declined more markedly among higher socioeconomic groups. However, little is known about changes in coronary risk factors in different socioeconomic groups. This study examined whether changes in established coronary risk factors in Britain over 20 years between 1978-80 and 1998-2000 differed between socioeconomic groups.

Explaining variation in referral from primary to secondary care: cohort study.

Objectives: To determine the extent to which referral for defined symptoms from primary care varies by age, sex, and social deprivation and whether any sociodemographic variations in referral differ according to the presence of national referral guidance and the potential of the symptoms to be life threatening.

Design: Cohort study using individual patient data from the health improvement network database in primary care.

Setting: United Kingdom.

Trends in longer-term survival following an acute myocardial infarction and prescribing of evidenced-based medications in primary care in the UK from 1991: a longitudinal population-based study.

Background: Both the incidence of myocardial infarction (MI) and short-term case fatality have declined in the UK. However, little is known about trends in longer-term survival following an MI. The aim of the study was to investigate trends in longer-term survival, alongside trends in medication prescribing in primary care.

Is the recent rise in type 2 diabetes incidence from 1984 to 2007 explained by the trend in increasing BMI?: evidence from a prospective study of British men.

Objective: To estimate the extent to which increasing BMI may explain the rise in type 2 diabetes incidence in British men from 1984 to 2007.

Research Design And Methods: A representative cohort ratio of 6,460 British men was followed-up for type 2 diabetes incidence between 1984 (aged 45-65 years) and 2007 (aged 67-89 years). BMI was ascertained at regular intervals before and during the follow-up.

Assessing the impact of medication use on trends in major coronary risk factors in older British men: a cohort study.

Aims: To investigate the role of medication in 20-year trends in blood pressure (BP) and blood lipids in older British men.

Methods And Results: BP and lipids were measured in 4231 men from a representative cohort at baseline (1978-1980, aged 40-59 years) and after 20 years (1998-2000). Cohort-wide age-adjusted 20-year mean changes were as follows: systolic BP -7.

Sociodemographic variations in the contribution of secondary drug prevention to stroke survival at middle and older ages: cohort study.

Objectives: To determine the extent to which secondary drug prevention for patients with stroke in routine primary care varies by sex, age, and socioeconomic circumstances, and to quantify the effect of secondary drug prevention on one year mortality by sociodemographic group.

Design: Cohort study using individual patient data from the health improvement network primary care database.

Setting: England.

How much of the recent decline in the incidence of myocardial infarction in British men can be explained by changes in cardiovascular risk factors? Evidence from a prospective population-based study.

Background: The incidence of myocardial infarction (MI) in Britain has fallen markedly in recent years. Few studies have investigated the extent to which this decline can be explained by concurrent changes in major cardiovascular risk factors.

Methods And Results: The British Regional Heart Study examined changes in cardiovascular risk factors and MI incidence over 25 years from 1978 in a cohort of 7735 men.

Continuous monitoring of long-term outcomes with application to hip prostheses.

The CUSUM continuous monitoring method could be a valuable tool in evaluating the performance (revision experience) of prostheses used in hip replacement surgery. The dilemma when applying the CUSUM in this context is the choice of statistical model for the outcome (revision). The Bernoulli model is perhaps the most straightforward approach but the Poisson model is a plausible, and could be argued, preferable alternative for long-term outcomes such as this, provided the rate of revision with time from surgery can be assumed to be constant.