{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:29:06Z","timestamp":1740104946277,"version":"3.37.3"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T00:00:00Z","timestamp":1494460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to assess the impact of regulatory action taken in June 2014 on the co\u2010prescribing of renin\u2013angiotensin system (RAS) blockers in UK primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>RAS blocker prescriptions, issued between 01\/01\/2009\u201330\/06\/2015, were extracted from the Clinical Practice Research Datalink to estimate the quarterly prevalence (number of patients with at least one co\u2010prescription) and incidence (number of patients first receiving a RAS blocker co\u2010prescription) of co\u2010prescribing. Two different RAS blockers prescribed on the same day constituted a co\u2010prescription.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 880\u00a0364 patients were prescribed a single RAS blocker during the study period. Prevalence of co\u2010prescribing increased from 4812 patients per million person\u2010years in Q1 2009 to 4865 in Q1 2010. A reduction then occurred decreasing to 2901 patients per million person\u2010years in Q2 2014 when the EU review concluded and continued to decrease thereafter despite a continued increase in the prevalence of prescribing of a single RAS blocker. Incidence of new co\u2010prescribing decreased from 454 patients per million person\u2010years in Q1 2009 to 159 in Q2 2014, but remained relatively constant at ~119 patients per million person\u2010years on average after the EU review concluded. A total of 96% of co\u2010prescriptions were for an ACE inhibitor\u00a0+\u00a0ARB, and 4% accounted for an ACE inhibitor or ARB\u00a0+\u00a0renin inhibitor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Recently, there has been a decrease in the prevalence and incidence of RAS blocker co\u2010prescribing. Reassuringly, overall co\u2010prescribing reduced in line with recommendations, although there was a decreasing trend prior to this likely due in part to prior publication of the data used in the EU review. \u00a9 2017 Crown copyright. Pharmacoepidemiology and Drug Safety \u00a9 2017 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4219","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T01:35:42Z","timestamp":1494552942000},"page":"858-862","source":"Crossref","is-referenced-by-count":8,"title":["The impact of regulatory action on the co\u2010prescribing of renin\u2013angiotensin system blockers in <scp>UK<\/scp> primary care"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-3856","authenticated-orcid":false,"given":"Craig","family":"Allen","sequence":"first","affiliation":[{"name":"Vigilance and Risk Management of Medicines Division Medicines and Healthcare Products Regulatory Agency (MHRA)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Donegan","sequence":"additional","affiliation":[{"name":"Vigilance and Risk Management of Medicines Division Medicines and Healthcare Products Regulatory Agency (MHRA)  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"EMA.Guideline on good pharmacovigilance practices: module XVI\u2014risk minimisation measures\u2014selection of tools and effectiveness indicators. Available at [http:\/\/www.ema.europa.eu\/ema\/index.jsp?curl=pages\/regulation\/document_listing\/document_listing_000345.jsp]. Accessed 20\/03\/2017."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2168479015570333"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f360"},{"key":"e_1_2_8_5_1","unstructured":"EMA.PRAC assessment report: for renin\u2010angiotensin system (RAS)\u2010acting agents. Procedure number: EMEA\/H\/A\u201031\/1370. 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