Journal: MedRxiv – the preprint server for health sciences
Authors: Rebecca Persson, Todd Sponholtz, Brenda N Baak, Susan S Jick
NLM Citation: Persson R, Sponholtz T, Baak B N, Jick S S. Strategy for identifying insulin pump use in Clinical Practice Research Datalink GOLD. medRxiv 302778 [Preprint]. February 13, 2024. Available from: DOI 10.1101/2024.02.13.24302778
Abstract
Background: Clinical Practice Research Datalink (CPRD) GOLD is an invaluable resource for clinical research. However, some exposures are difficult to capture, including continuous subcutaneous insulin infusion pump systems (“insulin pumps”). We present a strategy we developed to classify insulin pump users and to estimate the duration of pump use in CPRD GOLD. This was done to study adverse skin events in new adult pump users. Methods: Insulin pump users were defined as patients who had a specific insulin pump code (prescription for an insulin pump cartridge or clinical code for continuous insulin infusion) in their record. Duration of use was defined as the continuous use of any insulin formulation commonly used in pump systems before and after the insulin pump specific code. Each patient’s pump start and end dates were calculated programmatically and then confirmed by manual review of the patient’s CPRD record. Results: There were 1032 patients with an insulin pump specific code recorded in CPRD GOLD through December 2018, of which 302 met the inclusion criteria for our safety study. Due to high variability in the patterns of insulin use, programmatic determination of pump start and end dates was insufficient. The start and/or end dates of >50% of patients required adjustment upon manual review. Conclusions: Insulin pump users in CPRD GOLD could be easily identified using this strategy, but we may have missed additional insulin pump users without specific pump codes. The duration of pump use, however, was difficult to capture. This strategy, though time intensive, is a useful tool for the study of insulin pumps.
