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Abstract
Objective This paper aims to understand spatial and temporal trends in pregabalin prescribing and the relationship with deprivation across England at both general practice and clinical commissioning group (CCG) levels.
Design A set of 207 independent generalised additive models are employed to model the spatiotemporal trend of pregabalin prescribed and dispensed per 1000 population, adjusting for deprivation. The response variable is pregabalin prescribed in milligrams, with weighted Index of Multiple Deprivation (IMD), geographical location and time as predictors. The set of active prescribing facilities grouped within CCG is the unit of analysis.
Setting National Health Service open prescribing data; all general practices in England, UK between January 2015 and June 2017.
Population All patients registered to general practices in England, UK.
Results Adjusting for deprivation, a North–South divide is shown in terms of prescribing trends, with the North of England showing increasing prescribing rates during the study period on average, while in the South of England rates are on average decreasing. Approximately 60% of general practices showed increasing prescribing rate, with the highest being 4.03 (1.75 for the most decreasing). There were no apparent spatial patterns in baseline prescription rates at the CCG level. Weighted IMD score proved to be statistically significant in 138 of 207 CCGs. Two-thirds of CCGs showed more pregabalin prescribed in areas of greater deprivation. Whether the prescribing rate is high due to high baseline prescription rate or increasing rates needs to be specifically looked at.
Conclusions The spatial temporal modelling demonstrated that the North of England has a significantly higher chance to see increase in pregablin prescriptions compared with the South, adjusted for weighted IMD. Weighted IMD has shown positive impact on pregabalin prescriptions for 138 CCGs.
- epidemiology
- primary care
- spatio-temporal mapping
- NHS prescribing data
- pregabalin
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Footnotes
Contributors This is a joint work by ZZ, BT, BR and EL. EL provided medical comments and background. BT, BR and ZZ proposed the statistical approach to the study. ZZ practised the statistical modelling, data analyses and interpretations of the results. All authors were involved in the proposal and open discussion over the subject. All authors contributed to critical revision of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. The data available can be found at https://figshare.com/articles/GP_Prescription_of_Pregabalin_2015-2017/11653590.