48 Citations (Scopus)

Abstract

AIMS: The UK Clinical Practice Research Datalink (CPRD) is increasingly being used to investigate suicide-related adverse drug reactions. No studies have comprehensively validated the recording of suicide and nonfatal self-harm in the CPRD. We validated general practitioners' recording of these outcomes using linked Office for National Statistics (ONS) mortality and Hospital Episode Statistics (HES) admission data.

METHODS: We identified cases of suicide and self-harm recorded using appropriate Read codes in the CPRD between 1998 and 2010 in patients aged ≥15 years. Suicides were defined as patients with Read codes for suicide recorded within 95 days of their death. International Classification of Diseases codes were used to identify suicides/hospital admissions for self-harm in the linked ONS and HES data sets. We compared CPRD-derived cases/incidence of suicide and self-harm with those identified from linked ONS mortality and HES data, national suicide incidence rates and published self-harm incidence data.

RESULTS: Only 26.1% (n = 590) of the 'true' (ONS-confirmed) suicides were identified using Read codes. Furthermore, only 55.5% of Read code-identified suicides were confirmed as suicide by the ONS data. Of the HES-identified cases of self-harm, 68.4% were identified in the CPRD using Read codes. The CPRD self-harm rates based on Read codes had similar age and sex distributions to rates observed in self-harm hospital registers, although rates were underestimated in all age groups.

CONCLUSIONS: The CPRD recording of suicide using Read codes is unreliable, with significant inaccuracy (over- and under-reporting). Future CPRD suicide studies should use linked ONS mortality data. The under-reporting of self-harm appears to be less marked.

Original languageEnglish
Pages (from-to)145-157
Number of pages13
JournalBritish Journal of Clinical Pharmacology
Volume76
Issue number1
DOIs
Publication statusPublished - Jul 2013

Bibliographical note

© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

Structured keywords

  • Centre for Surgical Research

Keywords

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Clinical Coding
  • Databases, Factual
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • General Practitioners
  • Great Britain
  • Humans
  • Incidence
  • International Classification of Diseases
  • Male
  • Middle Aged
  • Self-Injurious Behavior
  • Sex Distribution
  • Suicide
  • Young Adult

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