Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review
Objectives To summarise the definitions and combinations of codes used to identify outcomes of anxiety, depression, fatigue, cognitive dysfunction (including mild cognitive dysfunction and dementia), sexual dysfunction, pain, sleep disorders, and fatal and non-fatal self-harm in studies using electr...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/7/e029227.full |
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| author | Rachael Williams Helen Strongman Helena Carreira Krishnan Bhaskaran |
| author_facet | Rachael Williams Helen Strongman Helena Carreira Krishnan Bhaskaran |
| author_sort | Rachael Williams |
| collection | DOAJ |
| description | Objectives To summarise the definitions and combinations of codes used to identify outcomes of anxiety, depression, fatigue, cognitive dysfunction (including mild cognitive dysfunction and dementia), sexual dysfunction, pain, sleep disorders, and fatal and non-fatal self-harm in studies using electronic health records from primary care databases in the UK.Design Systematic review.Data sources Medline, Embase and lists of publications of the main primary care databases in the UK.Eligibility criteria Included data from a UK primary care database and studied outcome(s) of interest.Data extraction and synthesis We abstracted information on the outcomes definition and codelists. When necessary, authors were contacted to request codelists.Results 120 studies were eligible. Codelists were available for 17/42 studies of depression; 21/41 studies of fatal and non-fatal self-harm; 17/27 studies of dementia/cognitive dysfunction; 5/12 studies of anxiety; 4/8 studies of pain; 3/6 studies of fatigue and sexual dysfunction; 1/2 studies of sleep disorders. Depression was most often defined using codes for diagnoses (37/42 studies) and/or antidepressants prescriptions (21/42 studies); six studies reported including symptoms in their definition. Anxiety was defined with codes for diagnoses (12/12 studies); four studies also reported including symptoms. Fatal self-harm was ascertained in primary care data linked to the Office for National Statistics mortality database in nine studies. Most studies of cognitive dysfunction included Alzheimer’s disease, and vascular and frontotemporal dementia. Fatigue definitions varied little, including chronic fatigue syndrome, neurasthenia and postviral fatigue syndrome. All studies of sexual dysfunction focused on male conditions, principally erectile dysfunction. Sleep disorders included insomnia and hypersomnia. There was substantial variability in the codelists; validation was carried out i21/120 studies.Conclusions There is a need for standardised definitions and validated list of codes to assess mental health and quality of life outcomes in primary care databases in the UK. |
| format | Article |
| id | doaj-art-da371d4296954fa697e995a1e418b963 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-da371d4296954fa697e995a1e418b9632025-08-20T02:32:48ZengBMJ Publishing GroupBMJ Open2044-60552019-07-019710.1136/bmjopen-2019-029227Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic reviewRachael Williams0Helen Strongman1Helena Carreira2Krishnan Bhaskaran3Clinical Practice Research Datalink, Medicines and Healthcare Products Regulatory Agency, London, UK1London School of Hygiene and Tropical Medicine, London, UK1 London School of Hygiene & Tropical Medicine, London, UK2 London School of Hygiene and Tropical Medicine, London, UKObjectives To summarise the definitions and combinations of codes used to identify outcomes of anxiety, depression, fatigue, cognitive dysfunction (including mild cognitive dysfunction and dementia), sexual dysfunction, pain, sleep disorders, and fatal and non-fatal self-harm in studies using electronic health records from primary care databases in the UK.Design Systematic review.Data sources Medline, Embase and lists of publications of the main primary care databases in the UK.Eligibility criteria Included data from a UK primary care database and studied outcome(s) of interest.Data extraction and synthesis We abstracted information on the outcomes definition and codelists. When necessary, authors were contacted to request codelists.Results 120 studies were eligible. Codelists were available for 17/42 studies of depression; 21/41 studies of fatal and non-fatal self-harm; 17/27 studies of dementia/cognitive dysfunction; 5/12 studies of anxiety; 4/8 studies of pain; 3/6 studies of fatigue and sexual dysfunction; 1/2 studies of sleep disorders. Depression was most often defined using codes for diagnoses (37/42 studies) and/or antidepressants prescriptions (21/42 studies); six studies reported including symptoms in their definition. Anxiety was defined with codes for diagnoses (12/12 studies); four studies also reported including symptoms. Fatal self-harm was ascertained in primary care data linked to the Office for National Statistics mortality database in nine studies. Most studies of cognitive dysfunction included Alzheimer’s disease, and vascular and frontotemporal dementia. Fatigue definitions varied little, including chronic fatigue syndrome, neurasthenia and postviral fatigue syndrome. All studies of sexual dysfunction focused on male conditions, principally erectile dysfunction. Sleep disorders included insomnia and hypersomnia. There was substantial variability in the codelists; validation was carried out i21/120 studies.Conclusions There is a need for standardised definitions and validated list of codes to assess mental health and quality of life outcomes in primary care databases in the UK.https://bmjopen.bmj.com/content/9/7/e029227.full |
| spellingShingle | Rachael Williams Helen Strongman Helena Carreira Krishnan Bhaskaran Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review BMJ Open |
| title | Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review |
| title_full | Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review |
| title_fullStr | Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review |
| title_full_unstemmed | Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review |
| title_short | Identification of mental health and quality of life outcomes in primary care databases in the UK: a systematic review |
| title_sort | identification of mental health and quality of life outcomes in primary care databases in the uk a systematic review |
| url | https://bmjopen.bmj.com/content/9/7/e029227.full |
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