Suchergebnisse

BACKGROUND: The risk of iatrogenic harm from the use and misuse of prescription drugs such as gabapentin, pregabalin, and oxycodone is substantial. In recent years, deaths associated with these drugs in England have increased. AIM: To characterise general practice prescribing trends for gabapentin, pregabalin, and oxycodone — termed dependence forming medicines (DFM) — in England and describe potential drivers of unwarranted variation (that is, very high prescribing). DESIGN & SETTING: This study is a retrospective secondary analysis of open source, publicly available government data from various sources pertaining to primary care demographics and prescriptions. METHOD: This study used 5 consecutive years (April 2013–March 2018) of aggregate data to investigate longitudinal trends of prescribing and variation in prescribing trends at practice and clinical commissioning group (CCG) level. RESULTS: Annual prescriptions of gabapentin, pregabalin, and oxycodone increased each year over the period. Variation in prescribing trends was associated with GP practice deprivation quintile, where the most deprived GP practices prescribed 313% (P<0.001) and 238% (P<0.001) greater volumes of gabapentin and pregabalin per person respectively, than practices in the least deprived quintile. The highest prescribing CCGs of each of these drugs were predominantly in northern and eastern regions of England. CONCLUSION: Substantial increases in gabapentin, pregabalin, and oxycodone prescriptions are concerning and will increase iatrogenic harm from drug-related morbidity and mortality. More research is needed to understand the large variation in prescribing between general practices, and to develop and implement interventions to reduce unwarranted variation and increase the appropriateness of prescribing of these drugs.

Aims: Little has been reported on self-harm among the UK Armed Forces, partly due to the difficulties in recording self-harm, within an often-difficult-to-reach population. This study assesses the lifetime prevalence of attempted suicide and self-harm within currently serving and ex-service personnel of the UK Armed Forces. Methods: Telephone interviews were conducted with 821 personnel who had previously participated in the King's Centre for Military Health Research military health study. Within the telephone interview, participants were asked about attempted suicide and episodes of self-harm. Results: A lifetime prevalence of 5.6% for intentional self-harm (self-harm or attempted suicide) was reported. Intentional self-harm was associated with psychological morbidity (in particular, post-traumatic stress disorder) and adverse experiences in childhood. Ex-service personnel reported lifetime prevalence more than double that of serving personnel (10.5% vs 4.2%, respectively). Participants reporting intentional self-harm were younger (34.4 years vs 39.8 years). Conclusion: A lifetime prevalence of 5.6% for attempted suicide and self-harm is higher than previous research has suggested. Younger service personnel, those who have experienced adversity in childhood, those with other psychological morbidity, and ex-service personnel are more likely to report self-harm behaviours.

Little is known about service personnel's perceptions of the media's coverage of war and its impact on the personnel and their families. Using data collected from a major cohort study of the British Armed Forces, this article examines perceptions of the coverage of the Iraq War among British personnel deployed during the 2003 invasion of Iraq (Operation Telic 1). It draws on the theories of media's effects and gauges whether hostile media effect or assimilation bias effect takes precedence. The authors qualitatively analyzed the responses of 200 military personnel regarding their perceptions of the media and supplemented this by further quantitative analysis. This led the authors to identify concerns that the media coverage was unsuitable, inaccurate, and too immediate; however, in some cases, coverage was considered beneficial. The importance of the family to those deployed and the extent to which media coverage can affect morale make the military family an important media audience.