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Primary care medical data: An alternative measure of smoking prevalence?

Author: Lisa Szatkowski
Institution: University of Nottingham
Type of case study: Research

About the research

Databases of electronic primary care records are widely used for research, but not currently as a source of national statistics on lifestyle issues such as smoking. There has been little contemporary research conducted into the quality of smoking data held within primary care, particularly since the NHS Quality and Outcomes Framework was introduced in 2004.

This study is vital to assess the potential for using large, longitudinal databases to monitor smoking trends. By using unique data from the General Household Survey (GHS), it aims to compare smoking data recorded within The Health Improvement Network database (THIN) with the accepted ‘gold standard’ for measuring smoking prevalence, to investigate the potential of using THIN data to track changes in smoking prevalence. But how successful could this approach be?

This study’s findings indicate that smoking data recording in THIN improved steadily in the study period. By 2008 there was good agreement between recorded smoking prevalence in THIN and the GHS-predicted prevalence. The GHS-predicted prevalence of current smoking in the THIN population was 21.8 per cent for men and 20.2 per cent for women, and the recorded prevalence was 22.4 and 18.9 per cent, respectively.

This indicates that data from electronic primary care databases such as THIN may provide an alternative means of monitoring national smoking prevalence. More specifically, the study results suggest that primary care medical records within THIN can be used to identify current smokers possibly with enough accuracy for use in monitoring smoking prevalence nationally. However, recording of ex-smokers and those who have never smoked is less complete.

Methodology

For each year from 2000 to 2008, the annual recorded prevalence of current smoking among patients in The Health Improvement Network (THIN) database was compared with the General Household Survey-predicted prevalence of smoking in the THIN population. Their relationship was calculated through indirect standardisation by applying age-, sex- and region-specific smoking rates from the corresponding GHS to the THIN population.

Publications

This research was featured in the following academic journal:

Szatkowski, L., Lewis, S., McNeill, A., Huang, Y. and Coleman, T. (2012) ‘Can data from primary care medical records be used to monitor national smoking prevalence?’ Journal of Epidemiology and Community Health, 66(9), pp. 791–795. doi: 10.1136/jech.2010.120154