Below are the database queries which are used to create this measure. These are run against a copy of the BSA prescribing data which we store in Google BigQuery. We're working on making our BigQuery tables publicly available at which point it will be possible to run and modify these queries yourself. But even where code and database queries are not directly useable by others we believe it is always preferable to make them public.
Description | Prescribing of high dose inhaled corticosteroids compared with prescribing of all inhaled corticosteroids |
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Why it matters | Latest BTS/SIGN guidance on the treatment of asthma recommends that patients should be maintained at the lowest possible dose of inhaled corticosteroid. Reduction in inhaled corticosteroid dose should be slow as patients deteriorate at different rates. Reductions should be considered every three months, decreasing the dose by approximately 25–50% each time. This measure uses table 12 of the BTS/SIGN guidance to define which inhalers are considered high-dose. The latest guidance for treatment of COPD now recommends use of another treatment in preference to inhaled corticosteroids. There is some evidence that inhaled corticosteroids increases the risk of pneumonia. This risk appears to increase with dose. |
Tags | Standard, Respiratory, Safety |
Implies cost savings | No |
Authored by | richard.croker |
Checked by | brian.mackenna |
Last reviewed | 2019-12-02 |
Next review due | 2020-06-02 |
Associated notebook | https://github.com/ebmdatalab/jupyter-notebooks/blob/master/ICS_code_differences/ICS_code_differences.ipynb |
History | View change history on GitHub → |
SELECT
CAST(month AS DATE) AS month,
practice AS practice_id,
SUM(items) AS numerator
FROM hscic.normalised_prescribing
WHERE bnf_code IN ("0302000C0AAACAC", "0302000C0AABWBW", "0302000C0AABZBZ", "0302000C0AACACA", "0302000C0BBAAAC", "0302000C0BFACAC", "0302000C0BFAFAU", "0302000C0BPADBW", "0302000C0BQABBZ", "0302000C0BRABCA", "0302000C0BTADBW", "0302000C0BUABBZ", "0302000C0BWABBZ", "0302000K0AAAHAH", "0302000K0AAAUAU", "0302000K0BBAIAH", "0302000K0BDACAU", "0302000K0BGACAH", "0302000K0BHABAU", "0302000K0BIAAAU", "0302000K0BJABAU", "0302000K0BKABAU", "0302000N0AAAUAU", "0302000N0AAAZAZ", "0302000N0AABCBC", "0302000N0AABGBG", "0302000N0AABKBK", "0302000N0BBAUAU", "0302000N0BBBABC", "0302000N0BCACAZ", "0302000N0BCAFBG", "0302000N0BDABBK", "0302000N0BFABBG", "0302000N0BGAAAZ", "0302000N0BGACBG", "0302000N0BHAAAZ", "0302000N0BIABBG", "0302000N0BIADAZ", "0302000N0BJABBG", "0302000N0BKABAZ", "0302000N0BLACBG", "0302000N0BMAAAZ", "0302000N0BNAAAZ", "0302000N0BPACBG", "0302000N0BRACAZ", "0302000U0AAABAB", "0302000U0BBABAB", "0302000V0AAAAAA", "0302000V0BBAAAA")
GROUP BY month, practice_id
SELECT
CAST(month AS DATE) AS month,
practice AS practice_id,
SUM(items) AS denominator
FROM hscic.normalised_prescribing
WHERE bnf_code IN ("0301011ABAAAAAA", "0301011ABBBAAA0", "0301011ABBBABAA", "0301011ABBBACAB", "0302000C0AAAAAA", "0302000C0AAABAB", "0302000C0AAACAC", "0302000C0AAARAR", "0302000C0AAASAS", "0302000C0AAATAT", "0302000C0AABEBE", "0302000C0AABFBF", "0302000C0AABGBG", "0302000C0AABHBH", "0302000C0AABJBJ", "0302000C0AABSBS", "0302000C0AABUBU", "0302000C0AABVBV", "0302000C0AABWBW", "0302000C0AABXBX", "0302000C0AABYBY", "0302000C0AABZBZ", "0302000C0AACACA", "0302000C0BBAAAC", "0302000C0BCAHAB", "0302000C0BCAIAA", "0302000C0BCAQAR", "0302000C0BEACAT", "0302000C0BFAAAA", "0302000C0BFABAB", "0302000C0BFACAC", "0302000C0BFADAS", "0302000C0BFAFAU", "0302000C0BFAGAR", "0302000C0BHADAK", "0302000C0BHAEAJ", "0302000C0BHAFAQ", "0302000C0BIAEBJ", "0302000C0BJAABE", "0302000C0BJABBF", "0302000C0BJACBG", "0302000C0BJADBH", "0302000C0BJAEBG", "0302000C0BJAFBH", "0302000C0BLABBJ", "0302000C0BNAABU", "0302000C0BPAABE", "0302000C0BPABBF", "0302000C0BPACBV", "0302000C0BPADBW", "0302000C0BQAABX", "0302000C0BQABBZ", "0302000C0BRAABY", "0302000C0BRABCA", "0302000C0BSAABE", "0302000C0BSABBF", "0302000C0BTAABE", "0302000C0BTABBV", "0302000C0BTACBF", "0302000C0BTADBW", "0302000C0BUAABX", "0302000C0BUABBZ", "0302000C0BVAABF", "0302000C0BVABBV", "0302000C0BWAABX", "0302000C0BWABBZ", "0302000K0AAAAAA", "0302000K0AAADAD", "0302000K0AAAGAG", "0302000K0AAAHAH", "0302000K0AAAIAI", "0302000K0AAAJAJ", "0302000K0AAAKAK", "0302000K0AAALAL", "0302000K0AAAMAM", "0302000K0AAAUAU", "0302000K0AAAVAV", "0302000K0AAAWAW", "0302000K0AAAZAZ", "0302000K0AABABA", "0302000K0AABBBB", "0302000K0AABCBC", "0302000K0BBADAD", "0302000K0BBAGAI", "0302000K0BBAHAG", "0302000K0BBAIAH", "0302000K0BBAJAJ", "0302000K0BBAKAK", "0302000K0BBAMAZ", "0302000K0BBANBA", "0302000K0BDAAAL", "0302000K0BDABAM", "0302000K0BDACAU", "0302000K0BDADBB", "0302000K0BDAEBC", "0302000K0BFAAAV", "0302000K0BFABAW", "0302000K0BGAAAK", "0302000K0BGABAG", "0302000K0BGACAH", "0302000K0BHAAAM", "0302000K0BHABAU", "0302000K0BIAAAU", "0302000K0BIABAM", "0302000K0BIADAL", "0302000K0BJAAAM", "0302000K0BJABAU", "0302000K0BKAAAM", "0302000K0BKABAU", "0302000N0AAAEAE", "0302000N0AAARAR", "0302000N0AAASAS", "0302000N0AAATAT", "0302000N0AAAUAU", "0302000N0AAAXAX", "0302000N0AAAYAY", "0302000N0AAAZAZ", "0302000N0AABABA", "0302000N0AABCBC", "0302000N0AABEBE", "0302000N0AABFBF", "0302000N0AABGBG", "0302000N0AABHBH", "0302000N0AABJBJ", "0302000N0AABKBK", "0302000N0AABLBL", "0302000N0AABPBP", "0302000N0AABQBQ", "0302000N0AABRBR", "0302000N0AABSBS", "0302000N0BBARAR", "0302000N0BBASAS", "0302000N0BBATAT", "0302000N0BBAUAU", "0302000N0BBAYBA", "0302000N0BBBABC", "0302000N0BBBBBH", "0302000N0BCAAAX", "0302000N0BCABAY", "0302000N0BCACAZ", "0302000N0BCADBE", "0302000N0BCAEBF", "0302000N0BCAFBG", "0302000N0BDAABJ", "0302000N0BDABBK", "0302000N0BDACBL", "0302000N0BDADBP", "0302000N0BDAEBQ", "0302000N0BFAABF", "0302000N0BFABBG", "0302000N0BGAAAZ", "0302000N0BGABBF", "0302000N0BGACBG", "0302000N0BHAAAZ", "0302000N0BIAABF", "0302000N0BIABBG", "0302000N0BIACAY", "0302000N0BIADAZ", "0302000N0BJAABF", "0302000N0BJABBG", "0302000N0BKAAAY", "0302000N0BKABAZ", "0302000N0BLAABE", "0302000N0BLABBF", "0302000N0BLACBG", "0302000N0BMAAAZ", "0302000N0BNAAAZ", "0302000N0BNABAY", "0302000N0BNACAX", "0302000N0BPAABE", "0302000N0BPABBF", "0302000N0BPACBG", "0302000N0BQAABR", "0302000N0BQABBS", "0302000N0BRAAAX", "0302000N0BRABAY", "0302000N0BRACAZ", "0302000R0AAAAAA", "0302000R0AAACAC", "0302000R0BBAAAA", "0302000R0BBACAC", "0302000U0AAAAAA", "0302000U0AAABAB", "0302000U0BBAAAA", "0302000U0BBABAB", "0302000V0AAAAAA", "0302000V0AAABAB", "0302000V0BBAAAA", "0302000V0BBABAB")
GROUP BY month, practice_id