Evidence map›Paper›PMID 37142468›Full record

ArticleSeminars in oncology nursing2023

A National Audit of Pancreatic Enzyme Prescribing in Pancreatic Cancer from 2015 to 2023 in England Using OpenSAFELY-TPP.

Agnieszka Lemanska, Colm Andrews, Louis Fisher, Ben Butler-Cole, Amir Mehrkar, Keith J Roberts, Ben Goldacre, Alex J Walker, Brian MacKenna, OpenSAFELY Collaborative

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Seminars in oncology nursing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Addressing the distressing: Pancreatic enzyme replacement therapy mitigates abdominal symptoms and weight loss during chemotherapy for advanced pancreatic cancer: A prospective study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Agnieszka LemanskaSenior Lecturer in Health Data Science, School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK. Electronic address: a.lemanska@surrey.ac.uk.
Colm AndrewsData scientist, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Louis FisherEpidemiologist & Health Data Scientist, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Ben Butler-ColeDirector of Engineering, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Amir MehrkarSenior Clinical Researcher, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Keith J RobertsConsultant Liver Transplant, Hepatobiliary and Pancreatic Surgeon & Honorary Professor, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
Ben GoldacreDirector & Bennett Professor of Evidence-Based Medicine, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Alex J WalkerEpidemiologist, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Brian MacKennaDirector of NHS Service Analytics, Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
OpenSAFELY Collaborative
University of Oxford · GBUniversity of Birmingham · GBUniversity of Surrey · GB

Funding

Department of Health COV-LT-0009Department of Health COV-LT2-0073Medical Research Council MC_PC_20030Medical Research Council MC_PC_20058Medical Research Council MC_PC_20059Medical Research Council MR/V015737/1Medical Research Council MR/W016729/1Medical Research Council MR/W021390/1Wellcome Trust 222097
6 · The paper itself

Abstract

objectivesCancer treatments were variably disrupted during the coronavirus disease 2019 (COVID-19) pandemic. UK guidelines recommend pancreatic enzyme replacement therapy (PERT) to all people with unresectable pancreatic cancer. The aim was to investigate the impact of the COVID-19 pandemic on PERT prescribing to people with unresectable pancreatic cancer and to investigate the national and regional rates from January 2015 to January 2023. DATA SOURCES: With the approval of NHS England, we conducted this study using 24 million electronic health records of people within the OpenSAFELY-TPP research platform. There were 22,860 people diagnosed with pancreatic cancer in the study cohort. We visualized the trends over time and modeled the effect of the COVID-19 pandemic with the interrupted time-series analysis.

conclusionIn contrast to many other treatments, prescribing of PERT was not affected during the pandemic. Overall, since 2015, the rates increased steadily over time by 1% every year. The national rates ranged from 41% in 2015 to 48% in early 2023. There was substantial regional variation, with the highest rates of 50% to 60% in West Midlands. IMPLICATIONS FOR NURSING PRACTICE: In pancreatic cancer, if PERT is prescribed, it is usually initiated in hospitals by clinical nurse specialists and continued after discharge by primary care practitioners. At just under 50% in early 2023, the rates were still below the recommended 100% standard. More research is needed to understand barriers to prescribing of PERT and geographic variation to improve quality of care. Prior work relied on manual audits. With OpenSAFELY, we developed an automated audit that allows for regular updates (https://doi.org/10.53764/rpt.a0b1b51c7a).

Indexed as

COVID-19Pancreatic NeoplasmsEnglandHumansPandemicsCOVID-19Electronic health recordsPancreatic cancerPancreatic cancer enzyme replacementPancreatic enzyme insufficiencyPrescribing auditQuality of care

Identifiers

PMID37142468
PMCPMC7616357
OpenAlexW4367693575

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.