Scientists have created a unique map of England and Wales that shows individual variations in the use of a single medicine. It is a drug called sodium valproate, also known as a treatment for serious epilepsy cause health problems for pregnant women.
The findings show drops in the use of drugs, responding to warnings about the effects, but the table reveals differences in dispensing patterns for women of childbearing age, with the highest rates found in local authorities in the north-west. and through the maritime regions in the east. These variations highlight potential disparities that need further investigation, the researchers warn.
Valproate is the main drug used to treat epilepsy and bipolar disorder, but it has also been linked to accidents, birth defects and cases of conditions such as ADHD and autism.
The medicines regulator MHRA said in 2016 that babies had been exposed to sodium valproate in the womb. high risk of serious developmental disorders. Around 20,000 children in the UK are estimated to have life-changing injuries caused by valproate. In addition, studies have suggested that children of people who receive the drug are at increased risk of neurological disorders.
“This is the first time we have been able to give different health characteristics and understand how a particular medicine is used in a population,” said the leader of the research team Reecha Sofat, professor of clinical pharmacology and therapeutics at the University of Liverpool. “What we have achieved suggests that we can provide benefits to the health service by understanding, at the grain level, how drugs are used in various areas.”
Valproate was selected for research because of recent concerns about its use. “It becomes a question of comparing neurological problems with pediatric care,” Sofat said. “If a person with epilepsy is resistant to all other drugs besides valproate, the medical problem is clear. What we needed, we understood, was a comprehensive picture of who was taking valproate and where.
The project is also important because it demonstrates the power of data-driven research, argues the team, which is supported by Health Data Research UK (HDR UK). By combining individual national data, it will be possible to describe how different drugs are used around the country. The potential for this use of data science is clear.
One future use would be to link anonymised mothers’ health data with children’s health records to improve doctors’ understanding of how drugs taken during pregnancy affect the health of the child, said another team member, Dr Caroline Dale, a research associate at the University of Liverpool.
“Pregnant women are often excluded from traditional research methods, such as clinical trials, which are concerned about unknown risks,” Dale said. “In this way, we have huge gaps in the knowledge of the results of safe drug use in this group. Our data approach is non-invasive and could be disseminated to better understand maternal health during pregnancy, combining this with child health records which helps us to understand the real-world effects of medicine.”
It should also be possible to monitor changes in other drugs being prescribed and reveal variations in the numbers of different drugs that people in different areas may be taking, say the researchers, whose work is outlined in the journal. BMJ Medicine this week
To carry out their research, scientists from the British Heart Foundation Data Science Center – supported by HDR UK – were allowed to use anonymized NHS health records, including primary care and hospital records, which they then combined to compile records for medicinal purposes: sodium valproate. These data were then first put together in this way.
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The research showed that between 2019 and 2023, the new use of sodium valproate fell from 7 to 5 per 100,000 women in the age group of 15-19, from 11 to 7 in the age group of 20-29, and from 14 to 7 in the age group of 30-39. .
Pregnancy rates dropped from 6.0 to 5.2 per 1,000 women treated with sodium valproate during the same period. There was no evidence that epilepsy-related deaths in women 15-49 increased in 2015-2022, but there was some evidence of a slight increase in men during the period April 2018 to December 2022.
“These are their inventions,” Sofat said. “They show an encouraging response in general to warnings about the dangers that should be taken with valprote, which, however, do not seem to be shared equally across the country.
“But what is also important to point out is that by providing access to different anonymous health databases, we can show insights into the ways in which drugs are used, allowing doctors to make all the better ways in which they are dispensed – and that can have the greatest benefits for the health service”.