Imperial College London


Faculty of MedicineSchool of Public Health

Research Associate



+44 (0)20 7594 2784r.newson Website




Mrs Pirkko Carmack +44 (0)20 7594 3368




351Reynolds BuildingCharing Cross Campus






BibTex format

author = {McKay, AJ and Newson, R and Soljak, M and Riboli, E and Car, J and Majeed, F},
doi = {10.1136/bmjopen-2015-008130},
journal = {BMJ Open},
title = {Are primary care factors associated with hospital episodes for adverse drug reactions? A national observational study.},
url = {},
volume = {5},
year = {2015}

RIS format (EndNote, RefMan)

AB - Objective Identification of primary care factors associated with hospital admissions for adverse drug reactions (ADRs).Design and setting Cross-sectional analysis of 2010–2012 data from all National Health Service hospitals and 7664 of 8358 general practices in England.Method We identified all hospital episodes with an International Classification of Diseases (ICD) 10 code indicative of an ADR, in the 2010–2012 English Hospital Episode Statistics (HES) admissions database. These episodes were linked to contemporary data describing the associated general practice, including general practitioner (GP) and patient demographics, an estimate of overall patient population morbidity, measures of primary care supply, and Quality and Outcomes Framework (QOF) quality scores. Poisson regression models were used to examine associations between primary care factors and ADR-related episode rates.Results 212813 ADR-related HES episodes were identified. Rates of episodes were relatively high among the very young, older and female subgroups. In fully adjusted models, the following primary care factors were associated with increased likelihood of episode: higher deprivation scores (population attributable fraction (PAF)=0.084, 95% CI 0.067 to 0.100) and relatively poor glycated haemoglobin (HbA1c) control among patients with diabetes (PAF=0.372; 0.218 to 0.496). The following were associated with reduced episode likelihood: lower GP supply (PAF=−0.016; −0.026 to −0.005), a lower proportion of GPs with UK qualifications (PAF=−0.035; −0.058 to −0.012), lower total QOF achievement rates (PAF=−0.021; −0.042 to 0.000) and relatively poor blood pressure control among patients with diabetes (PAF=−0.144; −0.280 to −0.022).Conclusions Various aspects of primary care are associated with ADR-related hospital episodes, including achievement of particular QOF indicators. Further investigation with individual level data
AU - McKay,AJ
AU - Newson,R
AU - Soljak,M
AU - Riboli,E
AU - Car,J
AU - Majeed,F
DO - 10.1136/bmjopen-2015-008130
PY - 2015///
SN - 2044-6055
TI - Are primary care factors associated with hospital episodes for adverse drug reactions? A national observational study.
T2 - BMJ Open
UR -
UR -
VL - 5
ER -