Cohort profile: prescriptions dispensed in the community linked to the national cancer registry in England

Abstract

PurposeThe linked prescriptions cancer registry data resource was set up to extend our understanding of the pathway for patients with cancer past secondary care into the community, to ultimately improve patient outcomes.ParticipantsThe linked prescriptions cancer registry data resource is currently available for April to July 2015, for all patients diagnosed with cancer in England with a dispensed prescription in that time frame.The dispensed prescriptions data are collected by National Health Service (NHS) Prescription Services, and the cancer registry data are processed by Public Health England. All data are routine healthcare data, used for secondary purposes, linked using a pseudonymised version of the patient’s NHS number and date of birth.Detailed demographic and clinical information on the type of cancer diagnosed and treatment is collected by the cancer registry. The dispensed prescriptions data contain basic demographic information, geography measures of the dispensed prescription, drug information (quantity, strength and presentation), cost of the drug and the date that the dispensed prescription was submitted to NHS Business Services Authority.Findings to dateFindings include a study of end of life prescribing in the community among patients with cancer, an investigation of repeat prescriptions to derive measures of prior morbidity status in patients with cancer and studies of prescription activity surrounding the date of cancer diagnosis.Future plansThis English linked resource could be used for cancer epidemiological studies of diagnostic pathways, health outcomes and inequalities; to establish primary care comorbidity indices and for guideline concordance studies of treatment, particularly hormonal therapy, as a major treatment modality for breast and prostate cancer which has been largely delivered in the community setting for a number of years.

Medicines associated with dependence or withdrawal: a mixed-methods public health review and national database study in England

“…We first extracted data on all antidepressants, opioids, gabapentinoids, benzodiazepines, and Z-drugs reported to the NHSBSA from April 1, 2015, to June 30, 2018, that had been prescribed by general practitioners' (GP) practices in England and dispensed to patients by retail pharmacies. In addition to NHS number (with pseudonymisation to protect confidentiality), 36 the following variables from the NHSBSA database were used: patient's sex and age; type of prescription form used; medicine class prescribed (using codes from the BNF); and the GP practice code. We assumed that methadone and buprenorphine prescriptions that used the BNF pain code on the FP10-MDA forms, used for controlled drug instalment dispensing, were for the treatment of opioid use disorder (ie, that the pain code was used in error), and these entries were removed.…”

Endocrine therapy in the years following a diagnosis of breast cancer: A proof of concept study using the primary care prescription database linked to cancer registration data

“…ET has contributed substantially to patient survival [12,13] and prior to the linkage of PCPD to cancer registration data in England, ET prescribing in women with breast cancer could not be reliably captured for the entire population [14,7]. A key strength of the PCPD is its national and near complete coverage [8]. The coverage of the study population by the PCPD was high, with 86% of patients having received a prescription during the reference period.…”

“…Women who died before 1st April 2015, those living outside of England and those with a date of death before the prescription was processed were excluded. This is because, in the PCPD, the date of the prescription is the date it was processed by the NHSBSA and in very few cases (0.3% of prescription items in the entire dataset [8]), this is after the patient’s death. We collected information on dates of birth, stage, ER and progesterone receptor (PR) status.…”

“…The Primary Care Prescription Database (PCPD) is an administrative database used to calculate reimbursement for prescriptions dispensed by community pharmacies. It contains demographic and drug information categorised according to the British National Formulary (BNF) version 68 [8]. The NHS Business Services Authority (NHSBSA) has partnered with the National Cancer Registration and Analysis Service (NCRAS), allowing cancer registration data to be linked with the PCPD.…”

Linkage of primary care prescribing records and pharmacy dispensing Records in the Salford Lung Study: application in asthma

“…Since 2015, NHSBSA dispensing data have included a patient identifier (NHS number) [ 25 ]; this is, however, not routinely linked to primary care prescribing records held by Public Health England (PHE). The NHSBSA and PHE records also do not have a common unique prescribing event identifier.…”