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…_jan_25 Update bdzper1000.json
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{ | ||
"name": "Anxiolytics and Hypnotics: Average Daily Quantity per 1000 patients", | ||
"title": "Anxiolytics and Hypnotics: Average Daily Quantity per 1000 patients", | ||
"description": "Number of average daily quantities (ADQs) of Anxiolytics and Hypnotics per 1000 patients", | ||
"numerator_short": "Anxiolytics and Hypnotics ADQ", | ||
"description": "Number of average daily quantities (ADQs) of oral Anxiolytics and Hypnotics per 1000 patients", | ||
"numerator_short": "Oral Anxiolytics and Hypnotics ADQ", | ||
"denominator_short": "1000 Patients", | ||
"y_label": "ADQ per 1000 patients", | ||
"why_it_matters": [ | ||
"Anxiolytics and Hypnotics are drugs that are prescribed for short-term treatment of conditions such as", | ||
"anxiety and sleep problems. <a href='https://www.rcpsych.ac.uk/expertadvice/treatments/benzodiazepines.aspx'> The Royal College of Psychiatrists states</a> ", | ||
"that \"around 4 in every 10 people who take them every day for more than 6 weeks will become addicted\" ", | ||
"and therefore they should not be prescribed for longer than 4 weeks. This measure shows the Average Daily Quantity (ADQ) of drug given per 1000 registered patients, ", | ||
"and therefore they should not be prescribed for longer than 4 weeks. This measure shows the Average Daily Quantity (ADQ) of oral drugs given per 1000 registered patients, ", | ||
"for both the older benzodiazepines, such as diazepam and temazepam, and the newer \"Z-drugs\", such as zopiclone. It excludes items that do not have ", | ||
"an ADQ, such as melatonin." | ||
"an ADQ, such as melatonin and daridorexant." | ||
], | ||
"tags": [ | ||
"core", | ||
|
@@ -24,23 +24,23 @@ | |
"is_cost_based": false, | ||
"low_is_good": true, | ||
"numerator_type": "custom", | ||
"numerator_columns": "SUM(p.quantity * r.percent_of_adq) AS numerator", | ||
"numerator_from": "{hscic}.normalised_prescribing p LEFT JOIN {hscic}.bdz_adq r ON concat(substr(p.bnf_code,0,9),substr(p.bnf_code,-2)) = concat(substr(r.bnf_code,0,9),substr(r.bnf_code,-2)) ", | ||
"numerator_columns": "SUM(p.total_adq_usage) AS numerator", | ||
"numerator_from": "{measures}.vw__bdz_total_adq p", | ||
"numerator_where": [ | ||
"p.bnf_code LIKE '0401%' AND --Hypnotics and Anxiolytics \n", | ||
"p.bnf_code NOT LIKE '0401010S0%' AND --Potassium bromide \n", | ||
"p.bnf_code NOT LIKE '0401010AC%' AND --Sodium Oxybate \n", | ||
"p.bnf_code NOT LIKE '0401010AD%' AND --Melatonin \n", | ||
"p.bnf_code NOT LIKE '0401020K0%AD' AND --Diazepam_Soln 5mg/2.5ml Rectal Tube \n", | ||
"p.bnf_code NOT LIKE '0401020K0%AE' AND --Diazepam_Soln 10mg/2.5ml Rectal Tube \n", | ||
"p.bnf_code NOT LIKE '0401020K0%BQ' --Diazepam_Soln 2.5mg/1.25ml Rectal Tube" | ||
"p.bnf_code NOT LIKE '0401040%' --Other hypnotics and anxiolytics \n" | ||
], | ||
"denominator_type": "list_size", | ||
"no_analyse_url": true, | ||
"authored_by": "[email protected]", | ||
"checked_by": "[email protected]", | ||
"date_reviewed": "2024-02-12", | ||
"next_review": "2025-02-12", | ||
"date_reviewed": "2025-01-20", | ||
"next_review": "2027-01-20", | ||
"measure_complexity": "medium", | ||
"measure_type": "custom", | ||
"radar_exclude": false | ||
} | ||
} | ||
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chemical_name,chemical_code,adq,adq_unit | ||
Lorazepam,0401020P0,2.5,mg | ||
Nitrazepam,0401010R0,5.0,mg | ||
Zopiclone,0401010Z0,7.5,mg | ||
Zaleplon,0401010W0,7.5,mg | ||
Zolpidem tartrate,0401010Y0,10.0,mg | ||
Diazepam,0401020K0,10.0,mg | ||
Temazepam,0401010T0,20.0,mg | ||
Oxazepam,0401020T0,30.0,mg | ||
Buspirone hydrochloride,0401020B0,30.0,mg | ||
Chlordiazepoxide hydrochloride,0401020E0,30.0,mg | ||
Clomethiazole,0401010F0,384.0,mg | ||
Lormetazepam,0401010P0,1.0,mg | ||
Loprazolam mesilate,0401010N0,1.0,mg | ||
Cloral betaine,0401010C0,1414.0,mg | ||
Clomethiazole edisilate,0401010D0,500.0,mg | ||
Chloral hydrate,0401010B0,1000.0,mg | ||
Meprobamate,0401020R0,1200.0,mg |
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-- this sql calculates the ADQ values for benzodiazepines | ||
SELECT | ||
rx.month AS month, | ||
rx.practice AS practice, | ||
rx.bnf_name AS bnf_name, | ||
rx.bnf_code AS bnf_code, | ||
SUM(quantity) AS quantity, | ||
SUM(items) AS items, | ||
strnt_nmrtr_val, -- strength numerator value from dmd | ||
strnt_nmrtr_uom, -- strength numerator unit of measurement from dmd | ||
strnt_dnmtr_val, -- strength denominator value from dmd | ||
strnt_dnmtr_uom, -- strength numerator unit of measurement from dmd | ||
adq.adq AS adq_value, | ||
SUM(quantity) * IEEE_DIVIDE( -- multiplies quantity by normalised adq value to get total usage value | ||
CASE | ||
WHEN strnt_nmrtr_uom = 258685003 THEN strnt_nmrtr_val / 1000 -- divides where uom is in micrograms by 1000 to get milligram value for consistency | ||
ELSE strnt_nmrtr_val | ||
END, | ||
COALESCE(strnt_dnmtr_val, 1) -- divides by unit size value, or 1 if this does not exist | ||
) / adq.adq AS total_adq_usage -- gets adq usage value normalised to mg | ||
FROM | ||
hscic.normalised_prescribing AS rx | ||
INNER JOIN | ||
dmd.vmp AS vmp | ||
ON CONCAT(SUBSTR(rx.bnf_code, 0, 9), SUBSTR(rx.bnf_code, -2)) = CONCAT(SUBSTR(vmp.bnf_code, 0, 9), SUBSTR(vmp.bnf_code, -2)) --joins "generic" BNF code to dm+d | ||
INNER JOIN | ||
dmd.vpi AS vpi | ||
ON vpi.vmp = vmp.id -- joins from vmp to vpi (where strengths are stored) | ||
INNER JOIN | ||
measures.adq_bdz AS adq --joins to bdz ADQ table | ||
ON SUBSTR(rx.bnf_code, 0, 9) = adq.chemical_code | ||
INNER JOIN | ||
dmd.droute AS droute -- joins to droute to get route codes | ||
ON vmp.id = droute.vmp | ||
INNER JOIN | ||
dmd.route AS route -- joins to route to get route names | ||
ON route.cd = droute.route | ||
WHERE | ||
route.descr = 'Oral' AND -- Oral preps only | ||
rx.bnf_code LIKE '0401%' -- Hypnotics and Anxiolytics | ||
GROUP BY | ||
month, | ||
rx.bnf_name, | ||
rx.bnf_code, | ||
rx.practice, | ||
strnt_nmrtr_val, | ||
strnt_nmrtr_uom, | ||
strnt_dnmtr_val, | ||
strnt_dnmtr_uom, | ||
adq.adq |