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515 results for “prescribing”
Plasma-Prescribed Active Region Static Extrapolation Dataset
<p>A repository of extrapolations using RBF-FD Magnetohydrostatic techniques with imposed plasmas, based on the SHARP solar image photospheric magnetic field library.</p>
ASS01 Suspended sediments in streams impacted by prescribed buring, grazing and woody vegetation removal at Konza Prairie
To determine effects of rotational burning and riparian vegetation removal on suspended solid concentrations in streams. Two sites are burned with a frequency of 2 (N02B) and 4 (N04D) years and grazed by bison. In 2011, N02B will have woody riparian vegetation removed along the entire stream length. The Shane Creek site (SHAN) is currently ungrazed and burned most years. In 2011 the treatment will be switched to grazing and burning of 1/3 of the watershed every year. The data include before and during-treatment sampling for both experiments.
Data for "Climate change is shifting and narrowing prescribed fire windows in the Western United States"
<p><strong>The data archived here represent two types of information used in the publication “Climate change is shifting and narrowing prescribed fire windows in the Western United States” by Swain et al. 2023:</strong></p> <p>1) The meteorological and vegetation dryness/fuel moisture data (as described within the file) extracted from prescribed fire burn plans around the Western United States (drawn from entities such as the U.S. Forest Service, U.S. National Park Service, and The Nature Conservancy) between 2002 and 2022. This data is provided in tabular form, both as an .xlsx file and a .csv file for the convenience of the user. In addition to the specific values from each burn plan, summaries of median values for forested and non-forested landscapes are provided as well.</p> <p>2) The number of days on which environmental conditions (i.e., weather and vegetation fuel moistures) are acceptable for prescribed fire according to the composite metric described in Swain et al. 2023 (known as “RxDays”). Underlying RxDay definitions are different for forest and non-forested landscapes. This data is provided in geospatially explicit (gridded) form as NetCDF files, which are a self-describing file format. Each file is provided as a single 3-dimensional hypercube (i.e., dimensions of time, latitude, and longitude, respectively; units and details described within the file) corresponding to the number of RxDays per calendar month.</p> <p>One file is provided for each climate model iteration (as identified in each filename); these represent projected RxDays at monthly scale between 1981 and 2060 using an RCP 4.5 climate forcing trajectory. An additional file (rx_gridMET.nc) is provided that represents the same values from an atmospheric reanalysis dataset, which represents a best estimate of observed RxDay values (1981-2020).</p>
The Plasma-Prescribed Active Region Static Extrapolation Dataset
<p>The Plasma-Prescribed Active Region Static Extrapolation (PARSE) Dataset consists of approximately seven thousand magnetohydrostatic extrapolations of solar active regions for use in statistical or machine learning applications. The extrapolations are based on the Spaceweather HMI Active Region Patch (SHARP) library (doi <a href="https://doi.org/10.1007/s11207-014-0529-3">10.1007/s11207-014-0529-3</a>), and the magnetohydrostatic extrapolation is performed by the routine detailed in Mathews et al 2022 (doi <a href="https://doi.org/10.1016/j.jcp.2022.111214">10.1016/j.jcp.2022.111214</a>). </p>
Long-term response of wetland plant communities to management intensity, grazing abandonment, and prescribed fire
Isolated, seasonal wetlands within agricultural landscapes are important ecosystems. However, they are currently experiencing direct and indirect effects of agricultural management surrounding them. Because wetlands provide important ecosystem services, it is crucial to determine how these factors affect ecological communities. Here, we studied the long-term effects of land use intensification, cattle grazing, prescribed fires, and their interactions on wetland plant diversity, community dynamics, and functional diversity. To do this, we used vegetation and trait data from a 14-year-old experiment on 40 seasonal wetlands located within semi-natural and intensively managed pastures in Florida. These wetlands were allocated different grazing and prescribed fire treatments (grazed vs. ungrazed; burned vs. unburned). Our results showed that wetlands within intensively managed pastures have lower native plant diversity, floristic quality, evenness, higher non-native species diversity, and exhibited the most resource-acquisitive traits. Wetlands embedded in intensively managed pastures were also characterized by lower species turnover over time. We found that 14 years of cattle exclusion reduced species diversity in both pasture management intensities and had no effect on floristic quality. Fenced wetlands exhibited lower functional diversity and experienced a higher rate of community change both due to an increase in tall, clonal, and palatable grasses. The effects of prescribed fires were often dependent on grazing treatment. For instance, prescribed fires increased functional diversity in fenced wetlands but not in grazed wetlands. Our study suggests that cattle exclusion and prescribed fires are not enough to restore wetlands in intensively managed pastures and further highlights the importance of not converting semi-natural pastures to intensively managed pastures. Our study also suggests that grazing levels applied in semi-natural pastures maintained high plant dive
2003 Prescribed Burn Effect on Chihuahuan Desert Grasses and Shrubs at the Sevilleta National Wildlife Refuge, New Mexico: Grass Recovery Study (2003-2018)
The U.S. Fish and Wildlife's plan to apply a prescribed burn to a large portion of McKenzie Flats was deemed an opportunity to study the effects of fire on vegetation at the boundary between shrubland and grassland. This study actually was undertaken on an area that had prescribed fire applied to 8 of 16 (300 m x 300 m) plots 10 years before in 1993. This previous study had also examined the effects of fencing to exclude the indigenous prong-horn antelope. In the 2003 study the prescribed fire was applied to the northeastern half of the 16 plots while the southwestern plots were intentionally protected. Sampling prior to the prescribed burn included quantification of cover of grass species in quadrats within all of the 16 plots. Measurements were made using "niner" quadrat frames that are 30 cm x 30 cm frames that are divided into 9 1-decimeter squares. Counts of grass species were made just prior to the June 2003 burn. Following the prescribed burn, quadrats were remeasured in the fall of 2003 to quantify mortality of grass species. These measurements were taken through the fall of 2012 and the fall of 2018. Measurements were not taken for 2014-2017.
2003 Prescribed Burn Effect on Chihuahuan Desert Grasses and Shrubs at the Sevilleta National Wildlife Refuge, New Mexico: Grass Recovery Study (2003-2018)
The U.S. Fish and Wildlife's plan to apply a prescribed burn to a large portion of McKenzie Flats was deemed an opportunity to study the effects of fire on the vegetation at the boundary between shrubland and grassland. This study actually was undertaken on an area that had prescribed fire applied to 8 of 16 (300 m x 300 m) plots 10 years before in 1993. This previous study had also examined the effects of fencing to exclude the indigenous prong-horn antelope. In the 2003 study the prescribed fire was applied to the northeastern half of the 16 plots while the southwestern plots were intentionally protected. Sampling prior to the prescribed burn included quantification of fuel load (ie. the standing biomass of all grasses and forbs in the area to be burned). These measurements were made using Daubenmire quadrat frames that are 5 cm x 20 cm and delineate a 0.1 square meter area. Four samples were taken adjacent to the six 3 m x 4 m quadrats in each of the eight plots that were to be burned. Quadrat frames were laid down over the vegetation and all vegetation rooted within the frame was clipped at ground level. This material was bagged, oven-dried and weighed. Following the prescribed burn, re-measurements were made every fall of from 2004 until 2012 when vegetation had reached its annual peak biomass. Data were not collected from 2014-2017, but were collected again in 2018.
2003 Prescribed Burn Effect on Chihuahuan Desert Grasses and Shrubs at the Sevilleta National Wildlife Refuge, New Mexico: Species Composition Study (2004-2018)
Disturbance from fire can affect the abundance and distribution of shrubs and grasses in arid ecosystems. In particular, fire may increase grass and forb production while hindering shrub encroachment. Therefore, prescribed fires are a common management tool for maintaining grassland habitats in the southwest. However, Bouteloua eriopoda (black grama), a dominant species in Chihuahuan Desert grassland, is highly susceptible to fire resulting in death followed by slow recovery rates. A prescribed fire on the Sevilleta National Wildlife refuge in central New Mexico in 2003 provided the opportunity to study the effects of infrequent fires on vegetation in this region. This study was conducted along a transition zone where creosote bushes (Larrea tridentata) are encroaching on a black grama grassland. Before and after the fire, above ground plant productivity and composition were monitored from 2003 to present. Following the prescribed fire, there were fewer individual grass clumps and less above ground grass cover in burned areas compared to unburned areas. This decrease in productivity was primarily from a loss of B. eriopoda. Specifically, B. eriopoda density and cover were significantly lower following the fire with a slow recovery rate in the five years following the fire. Other grasses showed no such adverse response to burning. Data were collected from 2004-2013 and 2018. Data were not collected for 2014-2017.
Data from: Thinning and prescribed burning increase shade-tolerant conifer regeneration in a fire excluded mixed-conifer forest
<p>Fire exclusion and past management have altered the composition, structure, and function of frequent-fire forests throughout western North America. In mixed-conifer forests of the California Sierra Nevada, fire exclusion has exacerbated the effects of drought and endemic bark beetles, resulting in extensive mortality of fire-adapted pine species. Thinning and prescribed fire are widely used in these forests to reduce fuels, moderate fire behavior, and restore ecosystems. Tree regeneration influences future forest composition and structure, and therefore future resilience to disturbances, but long-term effects of thinning and prescribed burning on tree regeneration after prolonged fire exclusion are poorly understood. We measured tree regeneration one year prior to, and periodically for 16 years following thinning and prescribed burning in a mixed-conifer forest in the Sierra Nevada, California, USA. We asked three questions. How did the composition and density of tree regeneration change after thinning and prescribed burning? Did pretreatment vegetation types influence conifer regeneration density after treatments? Did planting after overstory thinning increase regeneration density of native pine species?</p> <p>Sixteen years after treatments, combined natural regeneration of shade-tolerant white fir (Abies concolor) and incense-cedar (<em>Calocedrus</em> <em>decurrens</em>) averaged 2,032 trees per hectare (tph) after understory thinning, and 7,745 tph after understory thinning combined with prescribed burning, increases of 37% and 146% from pretreatment densities. In contrast, combined natural regeneration of white fir and incense-cedar averaged 497 tph after overstory thinning, 780 tph after overstory thinning with prescribed burning, 113 tph after prescribed burning alone, and 807 tph in untreated controls, all of which were declines from pretreatment densities. Natural regeneration of white fir and incense-cedar was consistently an order of magnitude greater than Jeffrey pine (<em>Pinus</em> <em>jeffreyi</em>) and sugar pine (<em>Pinus</em> <em>lambertiana</em>), whose combined densities 16 years after treatments averaged 37 tph across treatments and did not significantly respond to thinning and/or prescribed burning. Natural conifer regeneration after treatments varied by pre-treatment vegetation type (closed canopy, <em>Ceanothus</em> <em>cordulatus</em> shrub-dominated, and open sparse), with large increases of natural regeneration after understory thinning in closed canopy and <em>Ceanothus</em> shrub vegetation types. Planting increased sugar pine regeneration density after overstory thinning, marginally increased Jeffrey pine regeneration after overstory thinning combined with prescribed burning, and increased white fir regeneration after overstory thinning with and without burning. No treatments reduced white fir and incense-cedar natural regeneration while simultaneously increasing natural pine regeneration, suggesting new thinning, burning, and planting approaches may be required to meet regeneration restoration objectives.</p>
Comparison of Drug Prescribing Before and During the COVID-19 Pandemic - A Cross-national European Study. Pharmaceuticals Consumption data
<p>Data and code supporting the article:</p> <p><strong>Comparison of Drug Prescribing Before and During the COVID-19 Pandemic - A Cross-national European Study </strong></p> <p>Prescription data from January 2017 to March 2021 for the Czech Republic, Germany, Lithuania, Slovenia, Spain (Catalonia), Sweden, and the United Kingdom (Scotland).<br>Data include the codes of the Anatomical-Therapeutic-Chemical classification (ATC) and corresponding numbers of dispensed defined daily doses (DDDs) and packs, aggregated by country, month and ATC.</p> <p>For more information, see the accompanying document ReadMe.txt.</p>
Data and code: Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non‐randomised pilot study
<p>This is a dataset and Stata analytical code relating to prescribing issues identified in the GPP pilot feasibility study. The paper reporting this study has been published as follows: </p> <p>Cardwell K, Smith SM, Clyne B on behalf of the General Practice Pharmacist (GPP) Study Group, et al. Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care: a non-randomised pilot study. BMJ Open 2020;10:e035087. doi: 10.1136/bmjopen-2019-035087</p> <p>The abstract of the study is included below:</p> <p><strong>Objective:</strong> Limited evidence suggests integration of pharmacists into the general practice team could improve medicines management for patients, particularly those with multimorbidity and polypharmacy. This study aimed to develop and assess the feasibility of an intervention involving pharmacists, working within general practices, to optimise prescribing in Ireland.</p> <p><strong>Design:</strong> Non-randomised pilot study</p> <p><strong>Setting:</strong> Primary care in Ireland</p> <p><strong>Participants:</strong> Four general practices, purposively sampled and recruited to reflect a range of practice sizes and demographic profiles.</p> <p><strong>Intervention:</strong> A pharmacist joined the practice team for six months (10 hours/week) and undertook medication reviews (face-to-face or chart-based) for adult patients, provided prescribing advice, supported clinical audits, and facilitated practice-based education.</p> <p><strong>Outcome measures:</strong> Anonymised practice-level medication (e.g. medication changes) and cost data were collected. Patient-Reported Outcome Measure (PROM) data were collected on a subset of older adults (aged ≥65 years) with polypharmacy using patient questionnaires, before and six weeks after medication review by the pharmacist.</p> <p><strong>Results:</strong> Across four practices, 787 patients were identified as having 1,521 prescribing issues by the pharmacists. Issues relating to potentially inappropriate or high-risk prescribing were addressed most often by the prescriber (51.8%), compared to cost-related issues (7.5%). Medication changes made during the study equated to approximately €57,000 in cost savings assuming they persisted for 12 months. Ninety-six patients aged ≥65 years with polypharmacy were recruited from the four practices for PROM data collection and 64 (66.7%) were followed up. There were no changes in patients’ treatment burden or attitudes to deprescribing following medication review, and there were conflicting changes in patients' self-reported quality of life.</p> <p><strong>Conclusions:</strong> This non-randomised pilot study demonstrated that an intervention involving pharmacists, working within general practices is feasible to implement and has potential to improve prescribing quality. This study provides rationale to conduct a randomised controlled trial to evaluate the clinical and cost-effectiveness of this intervention.</p>
Projected Smoke Impacts from Increased Prescribed Fire Activity (PHIRE) Smoke Modeling Datasets
<p>This dataset support the publication, Kramer et al., 2023, submitted to JGR: Atmospheres on 01-13-2023</p> <p>This project was supported by a grant from the CAL FIRE Forest Health Research Program (Agreement #8GG19803), as part of California Climate Investments. California Climate Investments is a statewide program that puts billions of Cap-and-Trade dollars to work reducing greenhouse gas emissions, strengthening the economy, and improving public health and the environment—particularly in disadvantaged communities. This study has not been reviewed by the funding agency and may not represent their opinion and interpretation of the findings. We also would like to acknowledge all participating organizations in the PHIRE team: The California Department of Public Health- Sumi Hoshiko; The Sequoia Foundation- Jeff Sanchez; U.S. EPA- Ana G. Rappold; Michigan Technological University- Nancy French; the U.S. Forest Service- Leland Tarnay; and Sonoma Technology- Fred Lurmann, ShihMing Huang, Samantha J. Kramer, Crystal McClure, and Melissa Chaveste. Beyond the authors of this publication, we would also like to acknowledge Sonoma Technology team members Kenneth J. Craig and Anondo Mukherjee for their contributions.</p>
Prescribed control model dataset
<p>The dataset is associated with the LiftWEC H2020 research project deliverables "D5.5 Implementation of real-time controller", "D4.7 Open-access experimental data from 3D LiftWEC tests" and "D4.8 Report on physical modelling of three-dimensional LiftWEC concept". It represents a prescribed control of the cyclorotor’s rotational velocity, which was originally planned to test for 3D LiftWEC small scale prototype.</p>
24-hour Oral Morphine Equivalent Based Opioid Prescribing After Surgery
ClinicalTrials.gov study NCT04043143. IPD Sharing: NO. Countries: 1. Publications: 7.
Data from: Thinning and prescribed burning increase shade-tolerant conifer regeneration in a fire excluded mixed-conifer forest
Open the record for dataset details and reuse information.
Flint Hills, KS PurpleAir PM2.5 data from the 2022 prescribed fire season
Open the record for dataset details and reuse information.
Reintroduced grazers and prescribed fire effects on beetle assemblage structure and function in restored grasslands
<p>Ecological restoration seeks to re-establish functioning ecosystems, but planning and evaluation often focus on taxonomic community structure and neglect consumers and their functional roles. The functional trait composition of insect assemblages, which make up the majority of animal diversity in many systems, can reveal how they are affected by restoration management and the consequences for ecosystem function. We sampled ground beetle (Coleoptera: Carabidae) assemblages in restored tallgrass prairies varying in management with prescribed fire and reintroduced American bison (<i>Bison bison</i>) to describe their taxonomic and functional trait structure. We also measured seed and arthropod predation to relate management, beetle assemblage characteristics, and function, and to test if function is maximized by trait diversity, dominant trait values, or beetle abundance. Beetle assemblages primarily varied with restoration age, declining over time in richness and both taxonomic and functional diversity, but bison presence also influenced taxonomic composition. Prescribed fire reduced seed predation in summer and arthropod predation in fall. Although seed predation was unrelated to beetle assemblages, arthropod predation was greater in sites with higher abundances of carnivorous ground beetles. The relatively weak impacts of fire and bison on functional assemblage structure is a promising sign that these management disturbances, aimed at supporting a diverse native plant community, are not detrimental to beetle assemblages. The significance of reduced predator function following prescribed fire will depend on the restoration context and whether seed or arthropod predation relates to management goals.</p>
Geographic and specialty antibiotic prescribing in Medicare Part D, and its relationship with hospital acquired infections
<p>Datasets analyzed in the paper: Geographic and specialty antibiotic prescribing in Medicare Part D, and its relationship with hospital acquired infections.</p>
Data from: Past tree influence and prescribed fire exert strong controls on reassembly of mountain grasslands after tree removal
Woody-plant encroachment represents a global threat to grasslands. Although the causes and consequences of this regime shift have received substantial attention, the processes that constrain reassembly of the grassland state remain poorly understood. We experimentally tested two potentially important controls on reassembly—the past influence of trees and the effects of fire—in conifer-invaded grasslands (mountain meadows) of western Oregon. Previously, we had reconstructed the history of tree invasion at fine spatial and temporal resolution. Using small subplots (10 × 10 m) nested within larger (1-ha) experimental plots, we characterized the fine-scale mosaic of encroachment states, ranging from remnant meadow openings (minimally altered by trees) to century-old forests (lacking meadow species). Subsequently, we removed trees from six plots, of which three were broadcast burned and three remained unburned (except for localized burn piles). Within each plot, subplots were sampled before and periodically after tree removal to quantify the individual and interactive effects of past tree influence and fire on grassland community reassembly. Adjacent, uninvaded meadows served as references sites. 'Past tree influence' was defined as the multivariate (structural or compositional) distance of subplots to reference meadows prior to tree removal. 'Reassembly' was defined as the distance, or change in distance, to reference meadows at final sampling. Consistent with theory, we observed greater reassembly of plant community structure than of composition, as loss of meadow specialists was offset by establishment of disturbance-adapted meadow generalists of similar growth form. Nevertheless, 8 years after tree removal, most subplots remained structurally and compositionally distinct from reference meadows. Furthermore, fire had both destabilizing and inhibitory effects: it reduced survival of meadow specialists across the range of encroachment states and, where past tree influence was greater, it stalled reassembly by promoting expansion of a highly competitive native meadow sedge. The slow pace of reassembly, despite abundant open space, suggests strong seed limitation—a condition exacerbated by burning. We present a novel test of the importance of past tree influence and fire for restoration of tree-invaded grasslands, offering insights into how constraints on community reassembly vary along a continuum of tree-altered states.
Study protocol and data dictionary: Effectiveness of a GP delivered medication review in reducing polypharmacy and potentially inappropriate prescribing in older patients with multimorbidity in Irish primary care: a cluster randomised controlled trial (SPPiRE study)
<p><strong>Methods</strong></p> <p><strong>Study design and participants</strong></p> <p>The methods for the SPPiRE cluster RCT have been described in the trial protocol (21). This study is reported in line with the CONSORT 2010 cluster RCT checklist (22), see Appendix 1, and was approved by the Irish College of General Practitioners Research Ethics Committee. In brief, SPPiRE was a pragmatic two arm cluster RCT, with the intervention delivered to GP clusters and analysis of outcomes at the patient level. Information about the trial was publicised through a variety of GP research, teaching and training networks throughout Ireland. Eligible practices expressing an interest were formally invited. Practices were eligible to participate if they had at least 300 registered patients aged ≥65 years (based on the need to identify a sufficient number of eligible participants) and used either of the two Irish GP practice management systems (PMS) with over 80% national cover; this enabled use of a SPPiRE patient finder tool which was developed and embedded into these systems. Practices were excluded if they were currently involved in a medication management or prescribing trial or if they were unable to recruit at least five participants.</p> <p>Eligible patients were aged ≥65 years and prescribed ≥15 repeat medicines. A repeat medicine was defined as any unique item with a World Health Organisation Anatomical Therapeutic Chemical code on the patient’s current repeat prescription. Patients were excluded if they had been recruited into a practice that was unable to recruit at least four other participants, they were judged by their GP as unable to give informed consent or they were unable to attend the practice for a face to face medication review, (e.g. nursing home residents and house bound patients). Recruited GPs ran the SPPiRE patient finder tool and screened the generated list to ensure only eligible patients were invited. Practices who identified more than 40 eligible patients were supported in selecting a random sample of 30 patients to invite. All recruited practices and patients gave fully informed consent and baseline data was collected prior to practice allocation, to reduce the likelihood of selection bias.</p> <p><strong>Randomisation and masking</strong></p> <p>Recruited practices were allocated to intervention or control groups by minimisation using Minimpy software (23) by the trial statistician (FB) who had no knowledge of participating practices. Minimisation variables included practice size (number of GP sessions per week, 0-14, 14-28 and 28 or more) and location (urban, rural or mixed). Considering the nature of the intervention, it was not possible to blind GPs or patients to the intervention, however to reduce the risk of detection bias the two primary outcome measures; the number of repeat medicines and whether a PIP was present were assessed by an independent blinded pharmacist (MF).</p> <p><strong>Procedures</strong></p> <p>Intervention GPs received unique login details to the SPPiRE website where they had access to five training videos and a template for performing the SPPiRE medication review. The training videos provided background information on multimorbidity and polypharmacy, PIP, eliciting patient treatment priorities and conducting a brown bag medication review. GPs were instructed to book a double appointment and to ask their patients to bring all their medicines in to the medication review visit with them. The SPPiRE medication review process had two main components; gather and record information and then to discuss and agree changes with their patient based on the recorded information, with a focus on deprescribing medicines that were potentially inappropriate, figure 1. The website provided suggested treatment alternatives for identified PIP but all treatment decisions were ultimately at the discretion of the individual GP, based on their clinical judgement and their patients’ individual priorities.</p> <p>Control GPs delivered usual care during the six to twelve month study period. At the time of intervention delivery there was no structured chronic disease management programme in Irish primary care and many patients with multimorbidity attended multiple hospital specialists. In Ireland, the majority of people aged ≥70 years of age have access to free GP visits and medicines with some prescription charge co-payments. In the 65 – 69 year old age category a lower proportion have access to both free GP visits and prescription medicines. Access to specialists and diagnostics in secondary care is free for the entire population.</p> <p><strong>Outcomes</strong></p> <p>The two primary outcomes were the number of repeat medicines and the proportion of patients with any PIP, from a list of 34 pre-specified indicators (see Appendix 2). A series of secondary prescribing related outcome measure were pre-specified to allow a more in depth analysis of the effect of the intervention on prescribing. These were:</p> <ul> <li>The number of medicines stopped and started</li> <li>The proportion of patients with a reduction in significant polypharmacy (defined as ≥15 repeat medicines)</li> <li>The number of PIP</li> <li>The proportion of patients with a high risk PIP (see Appendix 2)</li> <li>The proportion of patients with any reduction in PIP</li> </ul> <p>Secondary patient reported outcomes measures were included to capture the effectiveness of the intervention from the patients’ perspective. These were:</p> <ul> <li>Health related Quality of life (EQ5D-5L)(24)</li> <li>Revised Patients' attitudes towards deprescribing (rPATD) (25)</li> <li>Multimorbidity Treatment Burden Questionnaire (MTBQ) (26)</li> </ul> <p>Health care utilisation data was collected to assess the effect of the intervention on health care usage and for the trial’s economic evaluation.</p> <p>Outcomes were collected at baseline and at six months after intervention delivery. Patient reported measures were collected by postal questionnaires. Data for all other measures including prescribed medicines, medical and investigations history and healthcare utilisation were collected by participating GPs and submitted to the study manager (CMC). This was a deviation from the original protocol, which indicated this data would be collected by the research team. This deviation related to changes in data protection and national health research regulations during the study period, which precluded research team access to the patients’ full clinical record.</p> <p><strong>Adverse events</strong></p> <p>Information on adverse events such as mortality, ED presentations and hospital admissions was collected at follow up. Given the deprescribing approach of the intervention a safety protocol for identifying and reporting any suspected adverse drug withdrawal events (ADWEs) was developed. An ADWE is defined as either recurrence of the condition for which the drug was prescribed (e.g. recurrence of angina after stopping a beta blocker) or a physiologic reaction to drug withdrawal (e.g. SSRI withdrawal syndrome) (27, 28). Although discontinuing medicines in older people has been demonstrated to be safe (29), given the paramount importance of the principle of “do no harm” in research ethics a vigorous and detailed method was established to ensure that any potential ADWEs precipitated by deprescribing in a SPPiRE medication review were captured. Intervention GPs were asked to report any possible ADWE following the SPPiRE medication review. The Naranjo ADR probability scale (30) has been adapted in other studies to assess the likelihood a reaction is related to drug withdrawal (27, 28). This tool was further adapted for SPPiRE and used to make an assessment on the causality of the ADWE. To ensure the patient perspective was included, self-reported possible ADWEs were also collected from patient follow up questionnaires. </p> <p> </p> <p><strong>Sample size</strong></p> <p>As outlined in the trial protocol (21), the study was designed with 90% power to detect a 20% reduction in the proportion with PIP and a mean difference of one medicine between intervention and control groups (based on a mean of 17.4 medicines SD (2.6)) and the sample size inflated to incorporate the effects of clustering (using an ICC of 0.025). The sample size was recalculated when it became apparent during early recruitment that it would not be possible to recruit clusters with an average of 15 participants, as was initially planned in the protocol. An average cluster size of eight was anticipated which inflated the original sample size from 30 practices (450 patients) to 50 practices (400 patients).</p> <p><strong>Statistical analysis</strong></p> <p>Descriptive statistics were used to describe baseline characteristics of recruited practices and participants. All analyses were conducted under the intention-to-treat principle and those lost to follow up had their baseline data carried forward. The primary analysis was carried out using multi-level modelling. The first primary outcome measure, number of repeat medications, was assessed using mixed effects Poisson regression with the individual as the unit of analysis and the practice included as the random effect to control for the effects of clustering and results presented using incidence rate ratios (IRR) and 95% confidence intervals (CI). The baseline number of medicines, GP size (number of GP sessions per week) and GP location (urban/rural) were included in the analysis as fixed effects. The second outcome measure, proportion of patients with a PIP, was analysed in a similar manner using mixed effects logistic regression, including PIP at baseline, GP size and location, and results presented using odd ratios (OR) and 95% CIs. A number of pre-specified sensitivity analyses were conducted; complete case analysis, per protocol analysis and including “presence of a repeat prescribing policy” as a covariate. All secondary outcomes were analysed in a similar manner to the primary outcomes, using appropriate mixed effects regression methods (i.e. linear, logistic, Poisson).</p> <p> </p> <p>Note: Version 3 (published 28 April 2025) updates Version 2 by removing Participant GP1P4 following consent withdrawal. This version should be used for all future analyses.</p> <p> </p>
ScienceDex guides
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These curated guides explain access requirements, typical timelines, costs, and reuse considerations for widely used research datasets.
Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
ABODe is a University of Edinburgh DataShare dataset for behavior classification in group-housed mice using home-cage video, identities, bounding boxes, ground-plate positions, and annotator labels.
DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.