The national healthcare system claims databases in France, SNIIRAM and EGB: Powerful tools for pharmacoepidemiology

“…The primary objective of this study was therefore to develop an algorithm to identify pregnancy episodes and related outcomes using the French health care databases, which covers 99% of the 67 million inhabitants in France . The secondary objective was to apply this algorithm to the analysis of antiepileptic drug (AED) use during pregnancy in France between 2007 and 2014.…”

Section: Introductionmentioning

confidence: 99%

Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Blotière

Weill

Dalichampt

et al. 2018

Pharmacoepidemiology and Drug

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PurposeAccess to claims databases provides an opportunity to study medication use and safety during pregnancy. We developed an algorithm to identify pregnancy episodes in the French health care databases and applied it to study antiepileptic drug (AED) use during pregnancy between 2007 and 2014.MethodsThe algorithm searched the French health care databases for discharge diagnoses and medical procedures indicative of completion of a pregnancy. To differentiate claims associated with separate pregnancies, an interval of at least 28 weeks was required between 2 consecutive pregnancies resulting in a birth and 6 weeks for terminations of pregnancy. Pregnancy outcomes were categorized into live births, stillbirths, elective abortions, therapeutic abortions, spontaneous abortions, and ectopic pregnancies. Outcome dates and gestational ages were used to calculate pregnancy start dates.ResultsAccording to our algorithm, live birth was the most common pregnancy outcome (73.9%), followed by elective abortion (17.2%), spontaneous abortion (4.2%), ectopic pregnancy (1.1%), therapeutic abortion (1.0%), and stillbirth (0.4%). These results were globally consistent with French official data. Among 7 559 701 pregnancies starting between 2007 and 2014, corresponding to 4 900 139 women, 6.7 per 1000 pregnancies were exposed to an AED. The number of pregnancies exposed to older AEDs, comprising the most teratogenic AEDs, decreased throughout the study period (−69.4%), while the use of newer AEDs increased (+73.4%).ConclusionsWe have developed an algorithm that allows identification of a large number of pregnancies and all types of pregnancy outcomes. Pregnancy outcome and start dates were accurately identified, and maternal data could be linked to neonatal data.

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“…The SNDS includes anonymous and prospectively recorded data on beneficiaries' characteristics, date of death, long‐term chronic disease (LTD), and all out‐of‐hospital health spending reimbursements . It also contains a medical summary of each hospitalization, including hospital discharge diagnoses, medical procedures, and expensive drugs dispensed during the stay …”

Section: Methods (More Details Are Presented In Appendix A)mentioning

confidence: 99%

Reduced risk of cancer among low‐dose aspirin users: Data from French health care databases

Ajrouche

Rycke

Dalichampt

et al. 2019

Pharmacoepidemiology and Drug

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Purpose The effect of chronic use of low‐dose aspirin (LDA) on overall cancer is still unclear owing to many controversial results and methodological limitations of studies. This study aimed to assess the effect of LDA use on overall cancer incidence among the French population. Methods We conducted a 10‐year historical cohort study using the permanent sample of the French national health care databases: the Système National des Données de Santé (SNDS). We used data for 111 025 individuals aged 50 to 80 years at study entry (January 1, 2006) without prevalent cancer or LDA use. Individuals were followed until the earliest of cancer incidence, death from any cause, exit from the database, or end of the study on December 31, 2015. We estimated the effect of LDA on cancer incidence by using a dynamic model to account for the competing risk of death in the presence of time‐dependent exposure and risk factors. Results LDA use was associated with reduced 10‐year risk of cancer (subdistribution hazard ratio [SHR] 0.81 [95% CI 0.77‐0.86]). The SHRs were 0.88 [0.82‐0.94] for men and 0.93 [0.85‐1.02] for women. Moreover, each additional year of LDA use was associated with reduced 10‐year risk of cancer (SHR 0.93 [0.92‐0.95]). LDA use was also associated with reduced 10‐year risk of death (SHR 0.86 [0.82‐0.91]). Conclusions This is the first population‐based study to demonstrate a protective effect of LDA on overall cancer incidence and to account for the main methodological issues of previous observational studies.

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The national healthcare system claims databases in France, SNIIRAM and EGB: Powerful tools for pharmacoepidemiology

Cited by 408 publications

References 61 publications

Comparison of Treatment Persistence with Dabigatran or Rivaroxaban versus Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients: A Competing Risk Analysis in the French National Health Care Databases

Comparison of Treatment Persistence with Dabigatran or Rivaroxaban versus Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients: A Competing Risk Analysis in the French National Health Care Databases

Development of an algorithm to identify pregnancy episodes and related outcomes in health care claims databases: An application to antiepileptic drug use in 4.9 million pregnant women in France

Reduced risk of cancer among low‐dose aspirin users: Data from French health care databases

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