Pharmacoepidemiology resources in Ireland—an introduction to pharmacy claims data

Sinnott, Sarah-Jo; Bennett, Kathleen; Cahir, Caitriona

doi:10.1007/s00228-017-2310-7

Cited by 58 publications

(89 citation statements)

References 45 publications

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“…The Health Services Executive–Primary Care Reimbursement Service (HSE‐PCRS) General Medical Services (GMS) scheme is a means‐tested system in Ireland providing prescribed medicines for a small co‐payment per item. The scheme covers approximately 1/3 of the population, but over‐represents females and the elderly . The HSE‐PCRS pharmacy claims database used for this study contains reimbursement records of medicines dispensed by pharmacies to patients in primary care.…”

Section: Methodsmentioning

confidence: 99%

Direct oral anticoagulants uptake and an oral anticoagulation paradox

Kennedy

Choitir

Clarke

et al. 2020

Brit J Clinical Pharma

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Oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation is underutilised. One of the impediments to warfarin therapy is the frequent monitoring required, usually at a specialised warfarin clinic. The advent of direct oral anticoagulants (DOACs) facilitates OAC therapy without an onerous monitoring regimen. This benefit may result in the more significant adoption of DOACs in areas without a warfarin clinic. This study analysed national administrative data for reimbursed pharmacy claims to assess OAC prescribing from 2010 to 2017 and compared the use of DOACs in areas with warfarin clinics compared to those without. Over the study period, the number of patients on OAC increased by 84%, due to a rapid increase in DOAC prescribing. The findings demonstrate that DOACs have resulted in an increase in the overall uptake of OAC therapy in Ireland. However, the increased utilisation was not evidently related to populations underserved by warfarin clinics.

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Section: Methodsmentioning

confidence: 99%

Direct oral anticoagulants uptake and an oral anticoagulation paradox

Kennedy

Choitir

Clarke

et al. 2020

Brit J Clinical Pharma

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“…A selection of TILDA participants eligible for the General Medical Services (GMS) scheme, a form of public health cover providing most health services free of charge, provided their GMS identifier. They consented for the use of this to examine medicines dispensed under the scheme, which was obtained from the Health Service Executive Primary Care Reimbursement Service . These data provide information relating to medications (product name, World Health Organization Anatomical Therapeutic Classification code and defined daily dose, and product strength) and the dispensing (date of dispensing and quantity dispensed).…”

Section: Methodsmentioning

confidence: 99%

Comparing Potentially Inappropriate Prescribing Tools and Their Association With Patient Outcomes

Moriarty

Bennett

Kenny

et al. 2019

J American Geriatrics Society

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OBJECTIVE To assess the agreement of several different measures of potentially inappropriate prescribing (PIP) in older people and compare their relationship with patient‐reported outcomes. DESIGN Prospective cohort study including participants in The Irish Longitudinal Study on Ageing (TILDA). SETTING Waves 1 and 2 of TILDA, a nationally representative aging cohort study. PARTICIPANTS A total of 1753 community‐dwelling TILDA participants with linked administrative pharmacy claims data on medications. MEASUREMENTS Potentially inappropriate medications were assessed using the Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) v1, American Geriatrics Society (AGS) Beers Criteria® 2012, and relevant Assessing Care of Vulnerable Elders (ACOVE) v3 indicators. Potential prescribing omissions were assessed using the Screening Tool to Alert Doctors to the Right Treatment (START) v1 and ACOVE v3 indicators. Their agreement was assessed via κ statistics, and multivariate regression was used to assess relationships with emergency department visits, general practitioner (GP) visits, quality of life, and functional decline (increased assistance needed for activities of daily living). RESULTS There was slight agreement between STOPP and AGS Beers Criteria® (κ = 0.20) and ACOVE indicators (κ = 0.15), while agreement between AGS Beers Criteria® and ACOVE indicators was fair (κ = 0.31). Agreement was fair between START and ACOVE indicators (κ = 0.34). All measures of inappropriate medications were significantly associated with increased GP visits. Only exposure to two or more START indicators was associated with reduced quality of life (adjusted mean difference = −1.12; 95% confidence interval [CI] = −1.92 to −0.33), and only two or more AGS Beers Criteria® were associated with functional decline (adjusted odds ratio = 2.11; 95% CI = 1.37‐3.28). For omissions, both measures were associated with functional decline, but only ACOVE indicators were associated with increased GP visits. CONCLUSION Prevalence of PIP and relationships with outcomes can differ substantially between tools with little agreement. Choice of PIP measure for research or practice should be considered in light of the circumstances and requirements in each case. J Am Geriatr Soc 68:526–534, 2020

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“…The Health Services Executive‐Primary Care Reimbursement Service (HSE‐PCRS) General Medical Services (GMS) scheme is a means‐tested system in Ireland providing prescribed medicines for a small copayment per item. The scheme covers approximately one third of the population, but over represents females and the elderly . The HSE‐PCRS pharmacy claims database used for this study contains reimbursement records of medicines dispensed by pharmacies to patients in primary care.…”

Section: Methodsmentioning

confidence: 99%

“…The scheme covers approximately one third of the population, but over represents females and the elderly. 22 The HSE-PCRS pharmacy claims database used for this study contains reimbursement records of medicines dispensed by pharmacies to patients in primary care. Non-prescription co-codamol products (paracetamol 500 mg/codeine 8 mg) as well as the two available cocodamol products with 30 mg of codeine were chosen.…”

Section: Health Services Executive-primary Care Reimbursement Servicementioning

confidence: 99%

Rates of reported codeine‐related poisonings and codeine prescribing following new national guidance in Ireland

Kennedy

Duggan

Bennett

et al. 2019

Pharmacoepidemiology and Drug

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Purpose The aims of this study were to examine a national database to assess codeine poisonings before and after the new guidance for pharmacists while also evaluating rates of codeine prescriptions following the introduction of restrictions on supply. Methods Anonymised enquiry data of reported poisoning cases were reviewed for a period from 2005 to 2016 inclusive. The rate of pharmacy claims for codeine containing products was also examined using the national pharmacy claims database. Segmented regression analysis was used to detect changes in poisonings and claims before and after the new guidance. Results There were 1851 codeine‐related poisonings reported over the study period. An annual decline was evident with a significant 33% reduction from 2010 to 2011 (β2 coefficient for level change, 42.1; 95% CI, −68.1 to −16.0; P = 0.006). Following 2011, the declining rate of codeine poisonings plateaued. Analysis of the national pharmacy claims data revealed no change in the reimbursement rate for co‐codamol products restricted by the guidance in 2010 (Incidence rate ratio 1.04, 95% CI, 0.997‐1.08; P = 0.07). There was no corresponding increase in the reimbursement of alternative opioid medications. Conclusions New guidance on codeine supply coincided with an initial reduction in reported codeine poisoning cases. This reduction was in keeping with the previous trend. However, this was without an increase in the prevailing rate of prescription claims for these products or potential substitutes. Policymakers may consider further restriction of codeine products to improve public health outcomes.

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Pharmacoepidemiology resources in Ireland—an introduction to pharmacy claims data

Cited by 58 publications

References 45 publications

Direct oral anticoagulants uptake and an oral anticoagulation paradox

Direct oral anticoagulants uptake and an oral anticoagulation paradox

Comparing Potentially Inappropriate Prescribing Tools and Their Association With Patient Outcomes

Rates of reported codeine‐related poisonings and codeine prescribing following new national guidance in Ireland

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