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Statins for extension of disability-free survival and primary prevention of cardiovascular events among older people: protocol for a randomised controlled trial in primary care (STAREE trial)
Introduction The world is undergoing a demographic transition to an older population. Preventive healthcare has reduced the burden of chronic illness at younger ages but there is limited evidence that these advances can improve health at older ages. Statins are one class of drug with the potential to prevent or delay the onset of several causes of incapacity in older age, particularly major cardiovascular disease (CVD). This paper presents the protocol for the STAtins in Reducing Events in the Elderly (STAREE) trial, a randomised double-blind placebo-controlled trial examining the effects of statins in community dwelling o...
Source: BMJ Open - April 3, 2023 Category: General Medicine Authors: Zoungas, S., Curtis, A., Spark, S., Wolfe, R., McNeil, J. J., Beilin, L., Chong, T. T.-J., Cloud, G., Hopper, I., Kost, A., Nelson, M., Nicholls, S. J., Reid, C. M., Ryan, J., Tonkin, A., Ward, S. A., Wierzbicki, A., On behalf of STAREE investigator group Tags: Open access, Cardiovascular medicine Source Type: research

The performance of seven QPrediction risk scores in an independent external sample of patients from general practice: a validation study
Conclusions Each of the algorithms performed practically as well in the external independent CPRD validation cohorts as they had in the original published QResearch validation cohorts.
Source: BMJ Open - August 28, 2014 Category: Journals (General) Authors: Hippisley-Cox, J., Coupland, C., Brindle, P. Tags: Open access, Epidemiology, General practice / Family practice, Health informatics Research Source Type: research

Implementing guidelines to routinely prevent chronic vascular disease in primary care: the Preventive Evidence into Practice cluster randomised controlled trial
Conclusions This intervention was associated with improved recording of some risk factors but no change in the level of risk at the follow-up audit. Trial registration number Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000578808, results.
Source: BMJ Open - December 11, 2015 Category: Journals (General) Authors: Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Russell, G., Mazza, D., Jayasinghe, U. W., Del Mar, C., Lloyd, J., Smith, J., Zwar, N., Taylor, R., Powell Davies, G., On behalf of the Preventive Evidence into Practice (PEP) Partnership Group, On be Tags: Open access, Cardiovascular medicine, Evidence based practice, General practice / Family practice, Health services research, Public health, Diabetes and Endocrinology Source Type: research

Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details
Conclusions Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions excluded patients with concomitant chronic conditions.
Source: BMJ Open - September 26, 2016 Category: Journals (General) Authors: Buffel du Vaure, C., Dechartres, A., Battin, C., Ravaud, P., Boutron, I. Tags: Open access, Evidence based practice, General practice / Family practice, Research methods Source Type: research

Comparison of self-perceived cardiovascular disease risk among smokers with Framingham and PROCAM scores: a cross-sectional analysis of baseline data from a randomised controlled trial
Conclusions Among smokers, misperception of their 10-year cardiovascular risk is common, with one-fifth underestimating it. These findings may help physicians target patients with such characteristics to help them change their health behaviour and adherence to risk-reduction therapy. Trial registration number NCT00548665; Post-results.
Source: BMJ Open - January 5, 2017 Category: Journals (General) Authors: Desgraz, B., Collet, T.-H., Rodondi, N., Cornuz, J., Clair, C. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Smoking and tobacco Research Source Type: research

Statin prescribing for people with severe mental illnesses: a staggered cohort study of 'real-world impacts
Conclusions We found that statin prescribing to people with SMI in UK primary care was effective for lipid modification but not CVD events. The latter finding may reflect insufficient power to detect a smaller effect size than that observed in randomised controlled trials of statins in people without SMI.
Source: BMJ Open - March 6, 2017 Category: Journals (General) Authors: Blackburn, R., Osborn, D., Walters, K., Falcaro, M., Nazareth, I., Petersen, I. Tags: Open access, Cardiovascular medicine, Epidemiology, General practice / Family practice, Mental health Research Source Type: research

Cohort profile: Outcomes & Multi-morbidity In Type 2 diabetes (OMIT) - a national registry-based observational cohort with focus on care and treatment of key high-risk groups in Norway
Purpose The ‘Outcomes & Multi-morbidity in Type 2 Diabetes’ (OMIT) is an observational registry-based cohort of Norwegian patients with type 2 diabetes (T2D) established to study high-risk groups often omitted from randomised clinical trials. Participants The OMIT cohort includes 57 572 patients with T2D identified via linkage of Norwegian Diabetes Register for Adults and the Rogaland-Oslo-Salten-Akershus-Hordaland study, both offering data on clinical patient characteristics and drug prescriptions. Subsequently these data are further linked to the Norwegian Prescription Database for dispensed medications,...
Source: BMJ Open - May 11, 2022 Category: General Medicine Authors: Forster, R. B., Strandberg, R. B., Bo Tibballs, K. L., Nokleby, K., Berg, T. J., Iversen, T., Hagen, T. P., Richardsen, K. R., Cooper, J., Sandberg, S., Lovaas, K. F., Nilsen, R. M., Iversen, M. M., Jenum, A. K., Buhl, E. S. S. Tags: Open access, Diabetes and Endocrinology Source Type: research

Clinical code usage in UK general practice: a cohort study exploring 18 conditions over 14 years
Conclusions This is an under-reported research area and the findings suggest the codes’ usage diversity for most conditions remained overall stable throughout the study period. Generated mental health code lists can last for a long time unlike cardiometabolic conditions and cancer. Adopting more consistent and less diverse coding would help improve data quality in primary care. Future research is needed following the transfer to the Systematised Nomenclature of Medicine Clinical Terms (SNOMED CT) coding.
Source: BMJ Open - July 25, 2022 Category: General Medicine Authors: Zghebi, S. S., Reeves, D., Grigoroglou, C., McMillan, B., Ashcroft, D. M., Parisi, R., Kontopantelis, E. Tags: Open access, General practice / Family practice Source Type: research

Conditions associated with the initiation of domiciliary care following a hospital admission: a cohort study in East London, England
Conclusion Hospitals are a major referral route into domiciliary care. While patients admitted due to new and acute illnesses account for many domiciliary care packages, exacerbations of long-term conditions and age-related and frailty-related conditions are also important drivers.
Source: BMJ Open - September 15, 2022 Category: General Medicine Authors: Grimm, F., Lewer, D., Craig, J., Rogans-Watson, R., Shand, J. Tags: Open access, Health services research Source Type: research

Cardiovascular-related conditions and risk factors in primary care for deprived communities before and during the COVID-19 pandemic: an observational study in Northern England
Conclusion Recorded CVD-related risk factors and conditions remained comparable before and during COVID-19. These are higher in the Deep End than in England and similar or lower than the non-Deep End, with a higher optimal statin prescribing rate. However, it was not possible to control for age and sex. More work is needed to estimate the consequences of the pandemic on disadvantaged communities and to compare whether the findings are replicated in other areas of deprivation.
Source: BMJ Open - November 22, 2022 Category: General Medicine Authors: Fu, Y., Price, C., Haining, S., Gaffney, B., Julien, D., Whitty, P., Newton, J. L. Tags: Open access, Public health, COVID-19 Source Type: research

Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Introduction General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. Methods and analysis This pro...
Source: BMJ Open - April 19, 2023 Category: General Medicine Authors: Douglas, J., Winkler, D., McLeod, A., Oliver, S., Gardner, K., Supple, J., Pearce, C. Tags: Open access, Health services research Source Type: research

Social bias in artificial intelligence algorithms designed to improve cardiovascular risk assessment relative to the Framingham Risk Score: a protocol for a systematic review
This study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provid...
Source: BMJ Open - May 31, 2023 Category: General Medicine Authors: Garcha, I., Phillips, S. P. Tags: Open access, General practice / Family practice Source Type: research

Screening over 100 000 patients in 39 general practices in the Netherlands for anticoagulation underprescription in atrial fibrillation: a descriptive, cross-sectional study
Conclusions In this large Dutch study among GPs, we observed 9.8% underprescription of OAC in AF patients. In 76% of the AF patients lacking a prescription for OAC, no documentation for deviating from the guidelines was found. Only in a minority of cases detection of OAC underprescription lead to OAC initiation.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Voorhout, L., Pisters, R., Geurts, C. H. P. H., Oostindjer, A., van Doorn, S., Rila, H., Fuijkschot, W. W., Verheugt, F., Hemels, M. E. W. Tags: Open access, Cardiovascular medicine Source Type: research

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