Vitamin B complex per 1000 patients

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 vitamin B complex (normal and strong tablets) per 1000 registered patients
Why it matters One of the most common reasons why vitamin B has been prescribed is to prevent Wernicke's encephalopathy in chronic alcohol disorders. A recent position statment from the Regional Medicines Optimisation Committee (RMOC) states that:

  • Due to a lack of evidence on their efficacy and safety, vitamin B complex preparations (vitamin B compound and vitamin B compound strong tablets) should not be prescribed for prevention of Wernicke’s Encephalopathy (WE) in alcoholism
  • Vitamin B complex preparations should not be prescribed for preventing deficiency or for maintenance treatment following treatment for deficiency.
  • Vitamin B complex preparations should not be prescribed as dietary supplements. Patients who wish to use them for dietary supplementation should be advised to purchase them over the counter.
  • Vitamin B compound strong tablets may be prescribed on a short-term basis (10 days) for patients at risk of refeeding syndrome. This also applies to patients who are not harmful or dependent drinkers.
  • In rare cases where there might be a justifiable reason for prescribing vitamin B complex e.g. medically diagnosed deficiency or chronic malabsorption, vitamin B compound strong and not vitamin B compound should be prescribed as it represents better value for money.

The RMOC advice is to review all existing patients prescribed vitamin B complex preparations with a view to stopping treatment in all but exceptional circumstances, such as in those patients with a medically diagnosed deficiency due to lifelong or chronic condition, or following surgery that results in malabsorption.

Tags Standard, Efficacy, NICE
Implies cost savings No
Authored by richard.croker
Checked by brian.mackenna
Last reviewed 2020-01-15
Associated notebook https://github.com/ebmdatalab/jupyter-notebooks/blob/master/new_measures/Vitamin%20B/New%20Measure%20-%20Vitamin%20B%20per%201000%20patients.ipynb
History View change history on GitHub →

Numerator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(items) AS numerator
 FROM hscic.normalised_prescribing
 WHERE bnf_code IN ("0906027G0AAAAAA", "0906027G0AAABAB", "0906027G0BFAAAB", "0906027G0BGABAA", "0906027G0BMAAAA", "0906027G0BMABAB")
 GROUP BY month, practice_id

Denominator SQL

SELECT
     CAST(month AS DATE) AS month,
     practice AS practice_id,
     SUM(total_list_size / 1000.0) AS denominator
 FROM hscic.practice_statistics
 GROUP BY month, practice_id