Data Resource Profile: MedicineInsight, an Australian national primary health care database

Busingye, Doreen; Gianacas, Christopher; Pollack, Allan; Chidwick, Kendal; Merrifield, Alistair; Norman, Sarah; Mullin, Bernie; Hayhurst, Rachel; Blogg, Suzanne; Havard, Alys; Stocks, Nigel

doi:10.1093/ije/dyz147

Cited by 93 publications

(206 citation statements)

References 10 publications

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“…We included all patients ≥18 years at the 445 general practice sites meeting the data quality requirements at the time the MedicineInsight data were extracted for this study in May 2018. (21) As some patients may have also visited general practices not contributing data to MedicineInsight, to maximise the probability of capturing relevant prescription and diagnostic information, we identified a cohort of regularly attending patients ("active patients"), who are likely to have received most of their care at participating practices. "Active patients" were Since 2005, pregabalin has been registered in Australia for treatment of neuropathic pain in adults, or adjunctive therapy in adults with partial seizures.…”

Section: Study Populationmentioning

confidence: 99%

Pregabalin prescribing patterns in Australian general practice, 2012–2018: a cross-sectional study

Schaffer

Busingye²,

Chidwick

et al. 2020

BJGP Open

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BackgroundIn 2013 pregabalin was subsidised by Australia’s Pharmaceutical Benefits Scheme (PBS) for neuropathic pain. Since the subsidy, pregabalin prescribing has been increasing in Australia and so has related harm. There are concerns it is being prescribed for indications other than neuropathic pain, which have little evidence of efficacy.AimTo describe pregabalin prescribing in Australian general practice.Design & settingA cross-sectional study of patients attending 445 general practice sites in the national MedicineInsight database from March 2012–February 2018.MethodThe following aspects were calculated: the proportion of prescriptions that were for pregabalin per year; the prevalence of pain conditions in patients prescribed pregabalin; and same-day prescribing of pregabalin with opioids or benzodiazepines.ResultsPrescribing increased from 13 per 10 000 to 104 per 10 000 prescriptions between 2012–2013 and 2017–2018. A total of 1 891 623 patients were identified of whom 114 123 (6.0%) were prescribed pregabalin; 49.7% (n = 56 772) had a recorded diagnosis of neuropathic pain. Among people prescribed pregabalin without a recorded diagnosis of neuropathic pain, 43.5% (n = 24 927) had a diagnosis of back problems, 8.8% (n = 5073) chronic pain, and 26.4% (n = 30 146) had no pain diagnosis. Pregabalin was prescribed the same day as an opioid to 38.1% of patients (95% confidence interval [CI] = 37.1% to 39.1%) and a benzodiazepine to 13.1% of patients (95% CI = 12.5% to 13.7%). Patients with a diagnosis of chronic pain had the highest rate of same-day prescribing of pregabalin with an opioid (70.4%, 95% CI = 68.9% to 71.9%) or a benzodiazepine (25.8%, 95% CI = 24.2% to 27.4%)ConclusionSubstantial increases in pregabalin prescribing were identified in Australian general practice, but only half of patients had a neuropathic pain diagnosis recorded, the only approved indication for subsidy. High rates of same-day prescribing with opioids and benzodiazepines may put patients at increased risk of harm.

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Section: Study Populationmentioning

confidence: 99%

Pregabalin prescribing patterns in Australian general practice, 2012–2018: a cross-sectional study

Schaffer

Busingye²,

Chidwick

et al. 2020

BJGP Open

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“…This is the first Australian study that evaluated potential drug interactions in patients prescribed DOACs, using the largest general practice dataset available to researchers. Busingye et al [25] investigated the national representativeness of the NPS MedicineWise dataset. While South Australia was underrepresented and Tasmania and New South Wales were overrepresented, the dataset was representative in terms of the age and gender of the participants based on comparisons with national Medical Benefits Schedule data.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study

Bezabhe

Bereznicki

Radford

et al. 2020

JCM

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Background: Co-prescribing medications that can interact with direct-acting oral anticoagulants (DOACs) may decrease their safety and efficacy. The aim of this study was to examine the co-prescribing of such medications with DOACs using the Australian national general practice dataset, MedicineInsight, over a five-year period. Methods: We performed five sequential cross-sectional analyses in patients with atrial fibrillation (AF) and a recorded DOAC prescription. Patients were defined as having a drug interaction if they had a recorded prescription of an interacting medication while they had had a recorded prescription of DOAC in the previous six months. The sample size for the cross-sectional analyses ranged from 5333 in 2014 to 19,196 in 2018. Results: The proportion of patients who had potential drug interactions with a DOAC decreased from 45.9% (95% confidence interval (CI) 44.6%–47.4%) in 2014 to 39.9% (95% CI 39.2%–40.6%) in 2018, p for trend < 0.001. During this period, the most frequent interacting class of medication recorded as having been prescribed with DOACs was selective serotonin/serotonin and norepinephrine reuptake inhibitor (SSRI/SNRI) antidepressants, followed by non-steroidal anti-inflammatory drugs (NSAIDs), calcium channel blockers (CCBs) and amiodarone. Conclusions: Overall, potential drug interactions with DOACs have decreased slightly over the last five years; however, the rate of possible interaction with SSRIs/SNRIs has remained relatively unchanged and warrants awareness-raising amongst prescribers.

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“…18 We, therefore, explored the prevalence of multimorbidity including the prevalence of individual, concordant and discordant LTCs and condition combinations, in a cohort of people with T2D attending Australian general practice using MedicineInsight which routinely collects electronic health record (EHR) data. 19 We also examined the associations between multimorbidity count (total, concordant and discordant) and HbA1c.…”

Section: Introductionmentioning

confidence: 99%

Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

et al. 2020

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ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

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Data Resource Profile: MedicineInsight, an Australian national primary health care database

Cited by 93 publications

References 10 publications

Pregabalin prescribing patterns in Australian general practice, 2012–2018: a cross-sectional study

Pregabalin prescribing patterns in Australian general practice, 2012–2018: a cross-sectional study

Five-Year Trends in Potential Drug Interactions with Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation: An Australian-Wide Study

Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

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