Medication codes - antiplatelet

angelwong121 commented 4 years ago

We need a codelist for identifying codelist for antiplatelet as one of the covariates.

brianmackenna commented 4 years ago

No problem - what is the rationale for this particular study? The BNF lists all antiplatelets here.

Do we want ton include them all? Antiplatelets have slight differences in what they can be used for.

There are other meds that inhibit platelet aggregation listed but I don't expect to see them in primary care.

angelwong121 commented 4 years ago

Thanks @brianmackenna , because we expect antiplatelets can prevent thrombotic events which might reduce the risk of severe COVID-19 outcomes. Therefore, I think we need to include them all antiplatelets although there might be different indications.

brianmackenna commented 4 years ago

@DarthCTR for ACE/ARB do you just want clopidogrel or do you need all antiplatelets?

DarthCTR commented 4 years ago

@brianmackenna A list for clopidogrel only is needed separately from a list of all antiplatelets. Clopidogrel has specific properties we want to test. Thank you!

brianmackenna commented 3 years ago

I have made a list of antiplatelets at

https://codelists.opensafely.org/builder/brian-mackenna/antiplatelet-medication/search/0209/?filter=included

I have included everything beginning with bnf code 0209

I have excluded

Abciximab(0209000W0): This is a mAB which will not be used in primary care - BNF advises specialist only
Ticlopidine hydrochloride(0209000U0): Not listed in BNF - only 14 scripts in last 12 months see Ticlodpine prescribing here
Eptifibatide(0209000X0): Not Rx in primary care - BNF advises specialist only

Further question/ consideration on "loading dose" preparations Background

See #20 for information on loading doses. Quite often antiplatelets are given as a once off at a substantially higher doses to speed up intial effect - this is called a "loading dose" and manufacturers will make higher dose preparations for hospitals. However we do see some small prescribing of these higher doses in primary care in low numbers. These may be valid due to rare disease/unique patient circumstances or they may be errors of some sort.

Questions

Do we want to include / exclude loading dose preparations from this list?
If we do exclude do we want a seperate list of loading dose preparations so people can be excluded from studies?

laurietomlinson commented 3 years ago

Unfortunately I can't see the codelist I assume the vast bulk of the data will be aspirin/clopidogrel/tigracelor - is there anything to lose by only including those drugs and not worrying about dose (since it is likely we will catch very few when they are on higher doses and they are unlikley to bias the results?

angelwong121 commented 3 years ago

@brianmackenna - can you help attach the codelist? the link that you showed lead to error. thanks

brianmackenna commented 3 years ago

A user has just pointed out that this codelist is still draft

https://www.opencodelists.org/codelist/opensafely/antiplatelets/15eb3bfc/

Are we happy with it as is?

angelwong121 commented 3 years ago

A user has just pointed out that this codelist is still draft

https://www.opencodelists.org/codelist/opensafely/antiplatelets/15eb3bfc/

Are we happy with it as is?

yes i think I signed this off

opensafely / anticoagulants-research

Medication codes - antiplatelet #12