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  • Royal College of General Practitioners  (3)
  • Evans, David  (3)
  • 1
    Online Resource
    Online Resource
    Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY
    Royal College of General Practitioners ; 2021
    In:  British Journal of General Practice Vol. 71, No. 712 ( 2021-11), p. e806-e814
    Details
    In: British Journal of General Practice, Royal College of General Practitioners, Vol. 71, No. 712 ( 2021-11), p. e806-e814
    Abstract: Long COVID describes new or persistent symptoms at least 4 weeks after onset of acute COVID-19. Clinical codes to describe this phenomenon were recently created. Aim To describe the use of long-COVID codes, and variation of use by general practice, demographic variables, and over time. Design and setting Population-based cohort study in English primary care. Method Working on behalf of NHS England, OpenSAFELY data were used encompassing 96% of the English population between 1 February 2020 and 25 May 2021. The proportion of people with a recorded code for long COVID was measured overall and by demographic factors, electronic health record software system (EMIS or TPP), and week. Results Long COVID was recorded for 23 273 people. Coding was unevenly distributed among practices, with 26.7% of practices having never used the codes. Regional variation ranged between 20.3 per 100 000 people for East of England (95% confidence interval [CI] = 19.3 to 21.4) and 55.6 per 100 000 people in London (95% CI = 54.1 to 57.1). Coding was higher among females (52.1, 95% CI = 51.3 to 52.9) than males (28.1, 95% CI = 27.5 to 28.7), and higher among practices using EMIS (53.7, 95% CI = 52.9 to 54.4) than those using TPP (20.9, 95% CI = 20.3 to 21.4). Conclusion Current recording of long COVID in primary care is very low, and variable between practices. This may reflect patients not presenting; clinicians and patients holding different diagnostic thresholds; or challenges with the design and communication of diagnostic codes. Increased awareness of diagnostic codes is recommended to facilitate research and planning of services, and also surveys with qualitative work to better evaluate clinicians’ understanding of the diagnosis.
    Type of Medium: Online Resource
    ISSN: 0960-1643 , 1478-5242
    URL: Article
    DOI: 10.3399/BJGP.2021.0301
    RVK:
    XA 34050
    Language: English
    Publisher: Royal College of General Practitioners
    Publication Date: 2021
    detail.hit.zdb_id: 2097982-4
    Location Call Number Limitation Availability
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Trends and clinical characteristics of COVID-19 vaccine recipients: a federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY
    Royal College of General Practitioners ; 2022
    In:  British Journal of General Practice Vol. 72, No. 714 ( 2022-01), p. e51-e62
    Details
    In: British Journal of General Practice, Royal College of General Practitioners, Vol. 72, No. 714 ( 2022-01), p. e51-e62
    Abstract: On 8 December 2020 NHS England administered the first COVID-19 vaccination. Aim To describe trends and variation in vaccine coverage in different clinical and demographic groups in the first 100 days of the vaccine rollout. Design and setting With the approval of NHS England, a cohort study was conducted of 57.9 million patient records in general practice in England, in situ and within the infrastructure of the electronic health record software vendors EMIS and TPP using OpenSAFELY. Method Vaccine coverage across various subgroups of Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts is described. Results A total of 20 852 692 patients (36.0%) received a vaccine between 8 December 2020 and 17 March 2021. Of patients aged ≥80 years not in a care home (JCVI group 2) 94.7% received a vaccine, but with substantial variation by ethnicity (White 96.2%, Black 68.3%) and deprivation (least deprived 96.6%, most deprived 90.7%). Patients with pre-existing medical conditions were more likely to be vaccinated with two exceptions: severe mental illness (89.5%) and learning disability (91.4%). There were 275 205 vaccine recipients who were identified as care home residents (JCVI group 1; 91.2% coverage). By 17 March, 1 257 914 (6.0%) recipients had a second dose. Conclusion The NHS rapidly delivered mass vaccination. In this study a data-monitoring framework was deployed using publicly auditable methods and a secure in situ processing model, using linked but pseudonymised patient-level NHS data for 57.9 million patients. Targeted activity may be needed to address lower vaccination coverage observed among certain key groups.
    Type of Medium: Online Resource
    ISSN: 0960-1643 , 1478-5242
    URL: Article
    DOI: 10.3399/BJGP.2021.0376
    RVK:
    XA 34050
    Language: English
    Publisher: Royal College of General Practitioners
    Publication Date: 2022
    detail.hit.zdb_id: 2097982-4
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    OpenSAFELY NHS Service Restoration Observatory 1: primary care clinical activity in England during the first wave of COVID-19
    Royal College of General Practitioners ; 2022
    In:  British Journal of General Practice Vol. 72, No. 714 ( 2022-01), p. e63-e74
    Details
    In: British Journal of General Practice, Royal College of General Practitioners, Vol. 72, No. 714 ( 2022-01), p. e63-e74
    Abstract: The COVID-19 pandemic has disrupted healthcare activity. The NHS stopped non-urgent work in March 2020, later recommending services be restored to near-normal levels before winter where possible. Aim To describe the volume and variation of coded clinical activity in general practice, taking respiratory disease and laboratory procedures as examples. Design and setting Working on behalf of NHS England, a cohort study was conducted of 23.8 million patient records in general practice, in situ using OpenSAFELY. Method Activity using Clinical Terms Version 3 codes and keyword searches from January 2019 to September 2020 are described. Results Activity recorded in general practice declined during the pandemic, but largely recovered by September. There was a large drop in coded activity for laboratory tests, with broad recovery to pre-pandemic levels by September. One exception was the international normalised ratio test, with a smaller reduction (median tests per 1000 patients in 2020: February 8.0; April 6.2; September 6.9). The pattern of recording for respiratory symptoms was less affected, following an expected seasonal pattern and classified as ‘no change’. Respiratory infections exhibited a sustained drop, not returning to pre-pandemic levels by September. Asthma reviews experienced a small drop but recovered, whereas chronic obstructive pulmonary disease reviews remained below baseline. Conclusion An open-source software framework was delivered to describe trends and variation in clinical activity across an unprecedented scale of primary care data. The COVD-19 pandemic led to a substantial change in healthcare activity. Most laboratory tests showed substantial reduction, largely recovering to near-normal levels by September, with some important tests less affected and recording of respiratory disease codes was mixed.
    Type of Medium: Online Resource
    ISSN: 0960-1643 , 1478-5242
    URL: Article
    DOI: 10.3399/BJGP.2021.0380
    RVK:
    XA 34050
    Language: English
    Publisher: Royal College of General Practitioners
    Publication Date: 2022
    detail.hit.zdb_id: 2097982-4
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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