A National Audit of Pancreatic Enzyme Prescribing in Pancreatic Cancer from 2015 to 2023 in England Using OpenSAFELY-TPP.
Agnieszka Lemanska, Colm Andrews, Louis Fisher and 6 others
PMID 37142468WHAT IT FOUND
The pandemic did not cause a sustained drop in primary-care pancreatic enzyme prescribing for adults with unresectable pancreatic cancer.
Rates were 48% by 2022 against a 100% target.
Key findings
01The pandemic did not affect overall PERT prescribing; a small dip from 46% to 43% between March and July 2020 recovered by September 2020.
02Against a 100% target, national PERT prescribing increased by about 1% every year, from 41% in 2015 to 48% by the end of 2022.
03Regional rates varied: West Midlands was highest at 50% to 60% from 2018, while London was lowest at 20% to 30%, but London is underrepresented.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only prescriptions issued in primary care were counted, so medicines supplied directly by hospitals may have been missed. Pancreatic cancer was identified from primary care codes rather than cancer registry linkage. The dataset did not include free text data. Seasonality was not accounted for in the model. The small statistically significant lower average trend during the pandemic cannot be directly interpreted as a pandemic effect. London is underrepresented, so regional comparisons involving London need caution. No individual-level analysis of different patient groups or socio-demographic inequalities was done.
Declared interests
One author received research funding from the Laura and John Arnold Foundation, NIHR, NHS England, the Wellcome Trust, Health Data Research UK, the Health Foundation, and other listed organisations, and is a Non-Executive Director at NHS Digital. Another author is employed as a pharmacist by NHS England and seconded to the Bennett Institute.
The easy way to misread this
Do not read the no-pandemic-effect finding as reassurance that prescribing is adequate. Rates were still 48% by 2022 against a 100% target.