Glaucoma treatment and deprivation: time-series analysis of general practice prescribing in England.

IF 2.5 Q2 PRIMARY HEALTH CARE
BJGP Open Pub Date : 2024-10-01 DOI:10.3399/BJGPO.2024.0005
Jeremy Hooper, Cecilia Helen Fenerty, James Roach, Robert Anthony Harper
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引用次数: 0

Abstract

Background: Despite advances in glaucoma management, topical eyedrop treatment has been paramount, with prostaglandin analogues (PGAs) being first-line agents. While late presentation is linked with deprivation, there is no recent research examining associations between deprivation and prescribing within primary care.

Aim: To explore PGA prescribing in general practice over a 6-year timeline, assessing associations with deprivation.

Design & setting: Analysis of NHS Business Services Authority (NHSBSA) data for general practice prescribing in England from April 2016-March 2022.

Method: Glaucoma treatments by GP prescribers were extracted, identifying ~9.11-9.58 million prescriptions/annum. Data were linked to Index of Multiple Deprivation (IMD) quintiles of GP practices. Crude rates per 1000 population were calculated using population data from NHS Digital. Time-series analyses facilitated comparison in prescribing nationally and in deprived areas. Autoregressive Integrated Moving Average (ARIMA) modelling facilitated measurement of synchrony between time series using cross correlation.

Results: PGAs and fixed combination eyedrops accounted for approximately two-thirds of glaucoma-related prescribing. Prescriptions per month increased slightly over a 6-year timeline, but rates per 1000 population reduced in 2020-2021 during the COVID-19 pandemic. The number of PGA prescriptions dispensed in deprived areas was lower than all other quintiles. Cross-correlation analysis indicates a lag of ~12 months between average PGA prescribing nationally versus more deprived areas.

Conclusion: The rate of PGA prescribing in primary care was substantially lower in deprived versus affluent areas, with delayed uptake of PGAs in more deprived areas of ~12 months. Further research is needed to explore reasons for this discrepancy, permitting strategies to be developed to reduce unwarranted variation.

青光眼治疗与贫困:英格兰全科处方的时间序列分析。
背景:尽管青光眼治疗取得了进展,但局部眼药水治疗一直是最重要的,前列腺素类似物(PGA)是一线药物。虽然晚期发病与贫困程度有关,但近期并无研究探讨贫困程度与初级医疗处方之间的关联。目的:探讨6年来在全科医疗中开具前列腺素类似物处方的情况,评估与贫困程度的关联:对英国国家医疗服务体系商业服务管理局(NHS Business Services Authority)2016 年 4 月至 2022 年 3 月期间英格兰全科处方数据进行分析:方法:提取全科医生处方中的青光眼治疗处方,确定约 911-958 万个处方/年。数据与全科医生诊所的多重贫困指数(IMD)五分位数相关联。使用 NHS Digital 的人口数据计算了每千人的粗略比率。时间序列分析有助于比较全国和贫困地区的处方情况。自回归综合移动平均(ARIMA)模型有助于利用交叉相关性测量时间序列之间的同步性:结果:PGAs 和固定组合眼药水约占青光眼相关处方的三分之二。在 6 年的时间跨度内,每月处方量略有增加,但到 2020-21 年,每千人的处方量有所减少。贫困地区的 PGA 处方开具率低于所有其他五分位数。交叉相关分析表明,全国的 PGA 平均处方量与较贫困地区的处方量之间存在约 12 个月的滞后期:结论:贫困地区与富裕地区相比,基层医疗机构的 PGA 处方率要低得多,较贫困地区的 PGA 使用滞后约 12 个月。需要进一步开展研究,探索造成这种差异的原因,以便制定策略,减少不必要的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJGP Open
BJGP Open Medicine-Family Practice
CiteScore
5.00
自引率
0.00%
发文量
181
审稿时长
22 weeks
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