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Associations between socioeconomic deprivation and pharmaceutical prescribing in primary care in England
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Mooney, Jessica, Yau, Roger, Moiz, Haseeb, Kidy, Farah, Evans, Andrew, Hillman, Sarah C., Todkill, Daniel and Shantikumar, Saran (2020) Associations between socioeconomic deprivation and pharmaceutical prescribing in primary care in England. Postgraduate Medical Journal . doi:10.1136/postgradmedj-2020-138944 (In Press)
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Official URL: https://doi.org/10.1136/postgradmedj-2020-138944
Abstract
Background Socioeconomic deprivation is associated with health inequality. Previous studies have described associations between primary care prescribing rates and deprivation for individual drugs or drug classes. We explore the correlation between socioeconomic deprivation and the rate of prescribing of individual pharmaceutical drugs, and drug classes, in primary care in England, to identify prescribing inequalities that would require further investigation.
Methods In this cross-sectional study, national primary care prescribing data, by GP practice, were retrieved for the calendar year 2019 in England. Socioeconomic deprivation was quantified using the Index of Multiple Deprivation (IMD) score. Correlations were calculated using Spearman’s rank correlation coefficient (), adjusting for practice list size and demographics, with a Bonferroni-corrected p value threshold of 5x10-5.
Results We included 1.05 billion prescription items dispensed from 6896 England practices. 142/206 (69%) drug classes and 505/774 (65%) drugs were significantly correlated with IMD score (p<5x10-5). Of the 774 included drugs, 31 (4%) were moderately positively associated with IMD score (>0.4). Only one was moderately negatively correlated with IMD score (< -0.4), suggesting higher prescribing rates in more affluent areas. The drug classes most strongly associated with IMD score included opioid and non-opioid analgesics, antipsychotics and reflux medications. Drug classes most strongly associated with affluence included adrenaline, combined oral contraceptives and hormone replacement therapy.
Conclusion We identify novel associations of prescribing with deprivation. Further work is required to identify the underlying reasons for these associations so that appropriate interventions can be formulated to address drivers of inequality.
| Item Type: | Journal Article | ||||||||
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| Alternative Title: | |||||||||
| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Health services accessibility, Medical care -- Regional disparities, Health -- Social aspects, Equality -- Health aspects, Medicine -- Research -- Social aspects, Drugs -- Prescribing -- Social aspects | ||||||||
| Journal or Publication Title: | Postgraduate Medical Journal | ||||||||
| Publisher: | BMJ | ||||||||
| ISSN: | 0032-5473 | ||||||||
| Official Date: | 2020 | ||||||||
| Dates: |
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| Date of first compliant deposit: | 17 November 2020 | ||||||||
| DOI: | 10.1136/postgradmedj-2020-138944 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | In Press | ||||||||
| Publisher Statement: | This article has been accepted for publication in Postgraduate Medical Journal following peer review. The definitive copyedited, typeset version is available online at: www.postgradmedj.com © Authors (or their employer(s)) 2020 | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Copyright Holders: | © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. | ||||||||
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