Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland

Henderson, David; Atherton, Iain; McCowan, Colin; Mercer, Stewart W; Bailey, Nick

doi:10.1093/ageing/afaa134

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…This method was adapted from one validated in other multimorbidity studies using administrative data. 21 Within each nation and for each dose, individuals were matched on their propensity to get vaccinated, area of residence and age. Matching on vaccination propensity was by single percentile bands of the propensity score and matching on age was by individual years up to 79 years, then 2year bands from ages 80 to 89 years, 5-year bands for those aged 90-99 years and one final band for all those aged 100 years.…”

Section: Discussionmentioning

confidence: 99%

Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: a pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales

Kerr

Bedston

Bradley

et al. 2022

International Journal of Epidemiology

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Background Several SARS-CoV-2 vaccines have been shown to provide protection against COVID-19 hospitalization and death. However, some evidence suggests that notable waning in effectiveness against these outcomes occurs within months of vaccination. We undertook a pooled analysis across the four nations of the UK to investigate waning in vaccine effectiveness (VE) and relative vaccine effectiveness (rVE) against severe COVID-19 outcomes. Methods We carried out a target trial design for first/second doses of ChAdOx1(Oxford–AstraZeneca) and BNT162b2 (Pfizer–BioNTech) with a composite outcome of COVID-19 hospitalization or death over the period 8 December 2020 to 30 June 2021. Exposure groups were matched by age, local authority area and propensity for vaccination. We pooled event counts across the four UK nations. Results For Doses 1 and 2 of ChAdOx1 and Dose 1 of BNT162b2, VE/rVE reached zero by approximately Days 60–80 and then went negative. By Day 70, VE/rVE was –25% (95% CI: –80 to 14) and 10% (95% CI: –32 to 39) for Doses 1 and 2 of ChAdOx1, respectively, and 42% (95% CI: 9 to 64) and 53% (95% CI: 26 to 70) for Doses 1 and 2 of BNT162b2, respectively. rVE for Dose 2 of BNT162b2 remained above zero throughout and reached 46% (95% CI: 13 to 67) after 98 days of follow-up. Conclusions We found strong evidence of waning in VE/rVE for Doses 1 and 2 of ChAdOx1, as well as Dose 1 of BNT162b2. This evidence may be used to inform policies on timings of additional doses of vaccine.

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Section: Discussionmentioning

confidence: 99%

Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: a pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales

Kerr

Bedston

Bradley

et al. 2022

International Journal of Epidemiology

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“…The priority given to clinically related data can create a task-orientated culture, preoccupied with physical and mental health. Data should include wider aspects of well-being, always maintaining a person-centred approach [ 30 ]. The ongoing DACHA study [ 6 ], and work on CDEs [ 4 , 5 ], will inform how this could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Developing a care home data platform in Scotland: a mixed methods study of data routinely collected in care homes

et al. 2022

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Background care homes collect extensive data about their residents, and their care, in multiple ways, for multiple purposes. We aimed to (i) identify what data are routinely collected and (ii) collate care home managers’ views and experiences of collecting, using and sharing data. Methods we examined data collected in six care homes across Lothian, Scotland. We extracted the meta-data, cross-referenced definitions and assessed the degree of harmonisation between care homes and with data sets currently in use in Scotland and internationally. We interviewed care home managers about their views and experiences of collecting, using and sharing data. Results we identified 15 core data items used routinely, with significant heterogeneity in tools and assessments used, and very limited harmonisation. Two overarching themes were identified of importance to the development of a care home data platform: (i) the rationale for collecting data, including to (a) support person-centred care, (b) share information, (c) manage workforce and budget and (d) provide evidence to statutory bodies and (ii) the reality of collecting data, including data accuracy, and understanding data in context. Discussion considerable information is collected by care home staff, in varied formats, with heterogeneity of scope and definition, for range of reasons. We discuss the issues that should be considered to ensure that individual resident-level form the strong foundations for any data platform for care homes, which must also include, robust infrastructure and clear interoperability, with appropriate governance. It must be co-produced by academics, policy makers and sector representatives, with residents, their families and care staff.

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“…This method was adapted from one validated in other multimorbidity studies using administrative data. 20 Medications related to contraceptives (BNF chapter 7, section 3) were removed as these do not indicate an illness, and medicines related to psychiatric morbidity (BNF chapter 4 sections 1, 2 and 3) were removed from this overall measure so that they could be investigated separately.…”

Section: Methodsmentioning

confidence: 99%

Variations in COVID-19 vaccination uptake among people in receipt of psychotropic drugs: cross-sectional analysis of a national population-based prospective cohort

et al. 2022

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Background Coronavirus disease 2019 (COVID-19) has disproportionately affected people with mental health conditions. Aims We investigated the association between receiving psychotropic drugs, as an indicator of mental health conditions, and COVID-19 vaccine uptake. Method We conducted a cross-sectional analysis of a prospective cohort of the Northern Ireland adult population using national linked primary care registration, vaccination, secondary care and pharmacy dispensing data. Univariable and multivariable logistic regression analyses investigated the association between anxiolytic, antidepressant, antipsychotic, and hypnotic use and COVID-19 vaccination status, accounting for age, gender, deprivation and comorbidities. Receiving any COVID-19 vaccine was the primary outcome. Results There were 1 433 814 individuals, of whom 1 166 917 received a COVID-19 vaccination. Psychotropic medications were dispensed to 267 049 people. In univariable analysis, people who received any psychotropic medication had greater odds of receiving COVID-19 vaccination: odds ratio (OR) = 1.42 (95% CI 1.41–1.44). However, after adjustment, psychotropic medication use was associated with reduced odds of vaccination (ORadj = 0.90, 95% CI 0.89–0.91). People who received anxiolytics (ORadj = 0.63, 95% CI 0.61–0.65), antipsychotics (ORadj = 0.75, 95% CI 0.73–0.78) and hypnotics (ORadj = 0.90, 95% CI 0.87–0.93) had reduced odds of being vaccinated. Antidepressant use was not associated with vaccination (ORadj = 1.02, 95% CI 1.00–1.03). Conclusions We found significantly lower odds of vaccination in people who were receiving treatment with anxiolytic and antipsychotic medications. There is an urgent need for evidence-based, tailored vaccine support for people with mental health conditions.

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Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland

Cited by 15 publications

References 18 publications

Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: a pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales

Waning of first- and second-dose ChAdOx1 and BNT162b2 COVID-19 vaccinations: a pooled target trial study of 12.9 million individuals in England, Northern Ireland, Scotland and Wales

Developing a care home data platform in Scotland: a mixed methods study of data routinely collected in care homes

Variations in COVID-19 vaccination uptake among people in receipt of psychotropic drugs: cross-sectional analysis of a national population-based prospective cohort

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