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Pharmacoepidemiology and Drug Safety
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License: CC BY
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Time Series Methods to Assess the Impact of Regulatory Action: A Study of UK Primary Care and Hospital Data on the Use of Fluoroquinolones

A Study of UK Primary Care and Hospital Data on the Use of Fluoroquinolones
Authors: Guo, Y; Raventós, B; Català, M; Elhussein, L; López‐Güell, K; Tan, E; Prats‐Uribe, A; +17 Authors

Time Series Methods to Assess the Impact of Regulatory Action: A Study of UK Primary Care and Hospital Data on the Use of Fluoroquinolones

Abstract

ABSTRACTPurposeTo illustrate the interest in using interrupted time series (ITS) methods, this study evaluated the impact of the UK MHRA's March 2019 Risk Minimisation Measures (RMM) on fluoroquinolone usage.MethodsMonthly and quarterly fluoroquinolone use incidence rates from 2012 to 2022 were analysed across hospital care (Barts Health NHS Trust), primary care (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD), and linked records from both settings (East Scotland). Rates were stratified by age (19–59 and ≥ 60 years old). Seasonality‐adjusted segmented regression and ARIMA models were employed to model quarterly and monthly rates, respectively.ResultsPost‐RMM, with segmented regression, both age groups in Barts Health experienced nearly complete reductions (> 99%); CPRD Aurum saw 20.19% (19–59) and 19.29% ( 60) reductions; no significant changes in CPRD GOLD; East Scotland had 45.43% (19–59) and 41.47% ( 60) decreases. Slope analysis indicated increases for East Scotland (19–59) and both CPRD Aurum groups, but a decrease for CPRD GOLD's 60; ARIMA detected significant step changes in CPRD GOLD not identified by segmented regression and noted a significant slope increase in Barts Health's 19–59 group. Both models showed no post‐modelling autocorrelations across databases, yet Barts Health's residuals were non‐normally distributed with non‐constant variance.ConclusionsBoth segmented regression and ARIMA confirmed the reduction of fluoroquinolones use after RMM across four different UK primary care and hospital databases. Model diagnostics showed good performance in eliminating residual autocorrelation for both methods. However, diagnostics for hospital databases with low incident use revealed the presence of heteroscedasticity and non‐normal white noise using both methods.

Keywords

Adult, 330, Databases, Factual, 610, Databases, Young Adult, Factual/statistics & numerical data, Humans, Primary Health Care/statistics & numerical data, interrupted time series, segmented regression, Primary Health Care, name=Epidemiology, Interrupted Time Series Analysis, Hospitals/statistics & numerical data, Middle Aged, risk minimisation measures, United Kingdom, Hospitals, Anti-Bacterial Agents, name=Pharmacology (medical), /dk/atira/pure/subjectarea/asjc/2700/2713, impact, /dk/atira/pure/subjectarea/asjc/2700/2736, regulatory interventions, autoregressive integrated moving average, Fluoroquinolones

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
2
Top 10%
Average
Average
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hybrid
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