PDF(Pubmed)
Abstract：
Electronic health records (EHRs) could identify long-term health effects of nicotine vaping. We characterised the extent to which vaping is recorded in primary care EHRs in the UK, on a population level.
We performed descriptive analysis of Clinical Practice Research Datalink (CPRD), primary care electronic health records of 25% of the UK population (~ 16 million patients). Patients aged ≥ 18 years whose vaping status was recorded using medical codes between 2006 and 2022 were identified. We reported the frequency of vaping codes; their distribution by patient age, gender, and ethnicity; trends in vaping recording over time (including interrupted time series analyses); and transitions in patient smoking status.
Seven medical codes indicated current or former vaping, from 150,114 patients. When their vaping status was first recorded, mean patient age was 50.2 years (standard deviation: 15.0), 52.4% were female, and 82.1% were White. Of those recorded as currently vaping, almost all (98.9%) had records of their prior smoking status: 55.0% had been smoking, 38.3% had stopped smoking, 5.6% had never smoked. Of those who were smoking prior to being recorded as vaping, more than a year after the vaping record, over a third (34.2%) were still smoking, under a quarter (23.7%) quit smoking, 1.7% received a \'never smoked\' status, and there was no smoking status for 40.4%. The \'e-cigarette or vaping product use-associated lung injury\' (EVALI) outbreak was significantly associated with a declining trend in new records of current vaping between September 2019 and March 2020; and an immediate significant increase in new records of former vaping, followed by a declining trend.
Few patients are being asked about vaping. Most who vape had smoked, and many quit smoking after starting vaping. To enable electronic health records to provide stronger evidence on health effects, we recommend improved completeness, accuracy and consistency.
We performed descriptive analysis of Clinical Practice Research Datalink (CPRD), primary care electronic health records of 25% of the UK population (~ 16 million patients). Patients aged ≥ 18 years whose vaping status was recorded using medical codes between 2006 and 2022 were identified. We reported the frequency of vaping codes; their distribution by patient age, gender, and ethnicity; trends in vaping recording over time (including interrupted time series analyses); and transitions in patient smoking status.
Seven medical codes indicated current or former vaping, from 150,114 patients. When their vaping status was first recorded, mean patient age was 50.2 years (standard deviation: 15.0), 52.4% were female, and 82.1% were White. Of those recorded as currently vaping, almost all (98.9%) had records of their prior smoking status: 55.0% had been smoking, 38.3% had stopped smoking, 5.6% had never smoked. Of those who were smoking prior to being recorded as vaping, more than a year after the vaping record, over a third (34.2%) were still smoking, under a quarter (23.7%) quit smoking, 1.7% received a \'never smoked\' status, and there was no smoking status for 40.4%. The \'e-cigarette or vaping product use-associated lung injury\' (EVALI) outbreak was significantly associated with a declining trend in new records of current vaping between September 2019 and March 2020; and an immediate significant increase in new records of former vaping, followed by a declining trend.
Few patients are being asked about vaping. Most who vape had smoked, and many quit smoking after starting vaping. To enable electronic health records to provide stronger evidence on health effects, we recommend improved completeness, accuracy and consistency.
摘要：
背景：电子健康记录（EHRs）可以识别尼古丁电子烟的长期健康影响。我们描述了在英国初级保健EHR中记录电子烟的程度，在人口水平上。
方法：我们对临床实践研究数据链（CPRD）进行了描述性分析，英国25%人口的初级保健电子健康记录(约1600万患者)。确定了年龄≥18岁的患者，其使用2006年至2022年之间的医疗代码记录了电子烟状态。我们报告了电子烟代码的频率；它们按患者年龄分布，性别,和种族；vaping记录随时间变化的趋势（包括中断的时间序列分析）；以及患者吸烟状况的转变。
结果：七个医疗代码表示当前或以前的电子烟，150,114名患者。当他们的电子烟状态第一次被记录时，患者平均年龄为50.2岁（标准差：15.0），52.4%是女性，白人占82.1%。在那些被记录为当前电子烟的人中，几乎所有人（98.9%）都有以前吸烟状况的记录：55.0%曾吸烟，38.3%的人戒烟，5.6%的人从未吸烟。在被记录为电子烟之前吸烟的人中，vaping记录一年多后，超过三分之一(34.2%)的人仍在吸烟，不到四分之一(23.7%)戒烟，1.7%的人获得了“从未吸烟”的状态，40.4%没有吸烟。“电子烟或电子烟产品使用相关肺损伤”（EVALI）爆发与2019年9月至2020年3月之间当前电子烟的新记录下降趋势显着相关;以及前电子烟的新记录立即显着增加，其次是下降的趋势。
结论：很少有患者被问及vaping。大多数vape吸烟的人，许多人在开始吸烟后戒烟。为了使电子健康记录能够提供更强有力的健康影响证据，我们建议改进的完整性，准确性和一致性。
方法：我们对临床实践研究数据链（CPRD）进行了描述性分析，英国25%人口的初级保健电子健康记录(约1600万患者)。确定了年龄≥18岁的患者，其使用2006年至2022年之间的医疗代码记录了电子烟状态。我们报告了电子烟代码的频率；它们按患者年龄分布，性别,和种族；vaping记录随时间变化的趋势（包括中断的时间序列分析）；以及患者吸烟状况的转变。
结果：七个医疗代码表示当前或以前的电子烟，150,114名患者。当他们的电子烟状态第一次被记录时，患者平均年龄为50.2岁（标准差：15.0），52.4%是女性，白人占82.1%。在那些被记录为当前电子烟的人中，几乎所有人（98.9%）都有以前吸烟状况的记录：55.0%曾吸烟，38.3%的人戒烟，5.6%的人从未吸烟。在被记录为电子烟之前吸烟的人中，vaping记录一年多后，超过三分之一(34.2%)的人仍在吸烟，不到四分之一(23.7%)戒烟，1.7%的人获得了“从未吸烟”的状态，40.4%没有吸烟。“电子烟或电子烟产品使用相关肺损伤”（EVALI）爆发与2019年9月至2020年3月之间当前电子烟的新记录下降趋势显着相关;以及前电子烟的新记录立即显着增加，其次是下降的趋势。
结论：很少有患者被问及vaping。大多数vape吸烟的人，许多人在开始吸烟后戒烟。为了使电子健康记录能够提供更强有力的健康影响证据，我们建议改进的完整性，准确性和一致性。
