General Practice Research Database

Bradbury et al. (2004), however, recently reanalyzed the relation between tamoxifen and cataracts and described it as a null association, They used a nested, matched, case-control study design and data collected in the General Practice Research Database. They identified all women 30-79 years old who were diagnosed with breast cancer and treated with tamoxifen within 6 months, or with bladder cancer, colorectal cancer, or nonmelanoma skin cancer between January 1991 and December i999. From this population they identified all newly diagnosed cases of cataract and matched four female controls to each case on age, index date, and study entry data. They assessed the risk of cataracts for current, past, and sometime users of tamoxifen... 

Seaman H, de Vries C, Farmer R. Venous thromboembolism associated with cyproterone acetate in combination with ethinyloestradiol (Dianette) observational studies using the UK General Practice Research Database. Pharmacoepidemiol Drug Saf 2004 13 427-36. 

A population of women aged 50-69 years old with at least one prescription for HRT were identified from Britain s General Practice Research Database, and a cohort of 50 000 women who had never used HRT was sampled from the same source population. The incidence... 

Majeed A, Moser K, Carroll K. Trends in the prevalence and management of atrial fibrillation in general practice in England and Wales, I 994-1 998 analysis of data from the general practice research database, Heart 2001 86(3) 284—288. 

The second study was a case-control study sponsored by Merck Co (the manufacturers of celecoxib), in which the risk of acute thromboembohc cardiovascular events among 16 937 patients aged 40-75 years with rheumatoid arthritis using naproxen was examined using the British General Practice Research Database (52). Each patient with a first... 

The above study was based on information derived from the General Practice Research Database in the UK. Subjects who had been given at least one prescription for dexfenfluramine, fenfluramine, or phentermine after 1 January 1988, and who were 70 years or younger at the time of their first prescription were included. Subjects were considered to have a new cardiac abnormality if they had no history, on the basis of clinical records, of cardiac valvular abnormahties and if there was evidence of a new valvular disorder on the basis of echocardiography or chnical examination after exposure to appetite suppressants. All the data had been recorded before the pubhcation of recent reports of an association between appetite suppressants and cardiac valve disorders (25,27,30-32) or primary pulmonary hjq)ertension (14). Hence, it was possible to exclude the possibihty that enhanced awareness of possible serious adverse effects of appetite suppressants had led to closer surveillance of patients who were taking these drugs. Nevertheless, the study did not provide information on the frequency of idiopathic cardiac valve disorders that are asymptomatic or otherwise not chnicaUy diagnosed. 

In a study using the UK General Practice Research Database to determine rates of drug-induced, rare, serious adverse effects on the liver, kidneys, skin, or blood, occurring within 45 days of completing a prescription or refill in 54 803 users of either fluconazole or itraconazole, three had illnesses for which a fluconazole-induced cause could not be ruled out one with thrombocytopenia, one with neutropenia, and one with an abnormal liver function test just after receiving fluconazole (31). The rates were 2.8/100 000 prescriptions (95% Cl = 0.8, 10) for serious, adverse blood events and 1.4/100 000 prescriptions (95% Cl = 0.25, 8.2) for serious, adverse liver events. These results suggest that fluconazole does not commonly have serious adverse effects on the liver, kidneys, skin, or blood. 

In a study using the UK General Practice Research Database to determine rates of rare, serious drug-induced, adverse effects on the hver, kidneys, skin, or blood, occurring within 45 days of completing a prescription or refill in 54 803 users of either fluconazole or... 

The risk of serious skin disorders has been estimated in 61 858 nsers, aged 20-79 years, of oral antifungal drugs identified in the UK General Practice Research Database... 

The more recent case-control study is that reported by Huerta et al [34A] using the General Practice Research Database from the United Kingdom. They confirmed that current use of NSAID increased the relative risk of AKI by 3.2 fold over non-users. They also identified significant increase in the relative risk of AKI when NSAID were combined with either diuretics (RR 11.6 (CL g 4.2-32.2)) or calcium channel blockers (RR 7.8 (3.0-20.5)). In addition, they provided analysis of individual NSAID relative risk. Diclofenac... 

Russmann S, Kaye JA, Jick SS, Jick H (2005) Risk of cholestatic liver disease associated with flucloxacillin and fiucloxacillin prescribing habits in the UK cohort study using data from the UK General Practice Research Database. Br J Clin Pharmacol 60 76-82 Rzany B, Correia O, Kelly JP, Naldi L, Auquier A, Stem R (1999) Risk of Stevens-Johnson syndrome and toxic epidermal necrolysis during first weeks of antiepileptic therapy a case-control study. Study group of the international case control study on severe cutaneous adverse reactions. Lancet 353 2190-2194... 

In a case-control study of data from 1993 to 1998 in the UK General Practice Research Database the risk of upper gastrointestinal bleeding or perforation was increased by slightly more than an additive effect in patients taking both aspirin and NSAIDs (8.2-fold), when compared with aspirin alone (2.4-fold), or NSAIDs alone (3.6-fold). The specifrc NSAIDs were not mentioned. Another study provided similar findings, as have studies... 

Retrospective cohort General Practice Research Database Acute Ml or death from coronary heart disease NSAID alone (417) NSAID with aspirin (163) Aspirin alone (1119) Non-NSAID users (1878) Incidence of acute Ml unaffected by NSAID alone. NSAID with aspirin similar to aspirin alone. 6... 

In a case-control study of the UK General Practice Research Database from 1993 to 1998 the risk of upper gastrointestinal bleeding or perfora-... 

Health-care insurance claims databases (managed by for-profit managed care organizations or government agencies) General Practice Research Database (United Kingdom)... 

Garda Rodriguez LA, Perez Gutthann S. 1998. Use of the UK general practice research database for pharmacoepidemiology. Br.. Clin. Pharmacol. 45 419-d 25. 

Pharmacoepidemiological studies can be set up from scratch (so-called field studies) but they are now normally conducted by using data collected for other purposes, e.g. from the General Practice Research Database in the UK or various health maintenance organisations in the USA. 

Skin Psoriasis Determination of the relative risk of psoriasis as a function of psychotropic medication has been studied in the UK General Practice Research Database [54 ], in which 36 702 cases of psoriasis were identified and the same number of matched controls. Use of psychotropic drugs was determined by current and four previous prescriptions. Long-term lithium... 

In a matched nested case-control study using data from the UK General Practice Research Database (GPRD) there were 875 cases of a lupus-like syndrome, of which 12% ( = 107) had evidence of a prescription for one or more of the suspected drugs, and they were compared with 3632 matched controls [68 ]. There was an increased risk of lupus-like syndrome with hydralazine (OR = 6.6, 95% CI = 1.03, 43), minocycline (OR = 4.2, 95% Cl = 2.7, 6.8) and carbamazepine (OR = 1.9, 95%... 

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