PrAna: an R package to calculate and visualize England NHS primary care prescribing data

Kishore Kumar Jagadeesan,Sue Griffin,Barbara Kasprzyk-Hordern,Ruth Barden,James Grant

doi:10.1186/s12911-021-01727-z

Abstract

BackgroundThe objective of this work to calculate prescribed quantity of an active pharmaceutical ingredient (API) in prescription medications for human use, to facilitate research on the prediction of amount of API released to the environment and create an open-data tool to facilitate spatiotemporal and long-term prescription trends for wider usage.DesignWe have developed an R package, PrAna to calculate the prescribed quantity (in kg) of an APIs by postcode using England’s national level prescription data provided by National Health Service, for the years 2015–2018. Datasets generated using PrAna can be visualized in a real-time interactive web-based tool, PrAnaViz to explore spatiotemporal and long-term trends. The visualisations can be customised by selecting month, year, API, and region.ResultsPrAnaViz’s targeted API approach is demonstrated with the visualisation of prescribed quantities of 14 APIs in the Bath and North East Somerset (BANES) region during 2018. Once the APIs list is loaded, the back end retrieves relevant data and populates the graphs based on user-defined data features in real-time. These plots include the prescribed quantity of APIs over a year, by month, and individual API by month, general practice, postcode, and medicinal form. The non-targeted API approach is demonstrated with the visualisation of clarithromycin prescribed quantities at different postcodes in the BANES region.ConclusionPrAna and PrAnaViz enables the analysis of spatio-temporal and long-term trends with prescribed quantities of different APIs by postcode. This can be used as a support tool for policymakers, academics and researchers in public healthcare, and environmental scientist to monitor different group of pharmaceuticals emitted to the environment and for prospective risk assessment of pharmaceuticals in the environment.

Highlights

The objective of this work to calculate prescribed quantity of an active pharmaceutical ingredient (API) in prescription medications for human use, to facilitate research on the prediction of amount of active pharmaceutical ingredients (APIs) released to the environment and create an open-data tool to facilitate spatiotemporal and long-term prescription trends for wider usage
PrAna and PrAnaViz enables the analysis of spatio-temporal and long-term trends with prescribed quan‐ tities of different APIs by postcode. This can be used as a support tool for policymakers, academics and researchers in public healthcare, and environmental scientist to monitor different group of pharmaceuticals emitted to the environ‐ ment and for prospective risk assessment of pharmaceuticals in the environment
In addition to its role in the prediction of environmental concentration in water, spatiotemporal data of human pharmaceutical consumption combined with other data could be used to explore and predict public health [13], for example, (1) prescription data for short-acting β2-agonists, and respiratory related prescribing could be used as a predictor for respiratory mortality and/or air pollution health effects [14,15,16], (2) antibiotic prescription data could be used as a predictor to measure antimicrobial resistance in the community [17,18,19], (3) reduction in the number of antidepressant prescriptions can be linked with an increase in the urban green space [20, 21], (4) opioids prescription monitoring could be used to assess community mental health [22, 23]

Summary

Introduction

The objective of this work to calculate prescribed quantity of an active pharmaceutical ingredient (API) in prescription medications for human use, to facilitate research on the prediction of amount of API released to the environment and create an open-data tool to facilitate spatiotemporal and long-term prescription trends for wider usage. During the last decade a wide range of pharmaceuticals have been identified and quantified in the aquatic environment across several countries and their impacts on exposed environmental species [1,2,3,4] and humans [5] have been reported. Despite its importance in environmental risk assessment and support in predicting public health, estimation of the human pharmaceutical consumption or the total manufactured amount is difficult. In those countries where the data is publicly available, it is complex and not straight-forward to handle. In the UK, since December 2011, the National Health Service (NHS) has made national prescription data publicly available at general practice (GP) level, reporting the item counts, quantity and cost of prescriptions aggregated by British National Formulary (BNF) code [13]

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Discussion

Conclusion