Status
Ongoing
Title
Impact of GP intervention and smoking cessation on secondary prevention of cardiovascular disease in individuals diagnosed with coronary heart disease and stroke
What is the aim of the study and why is it important?
Tobacco smoking has been associated with increased likelihood of having a heart attack or stroke, it follows that stopping smoking may have a beneficial effect on cardiovascular health and potentially help reduce the risk of having a second heart attack or stroke. We aim to assess whether stopping smoking reduces the risk of secondary cardiovascular disease for individuals diagnosed with coronary heart disease or stroke.
To achieve this aim we will address the following research questions:
1. What frequency and types of services are offered by doctors to support quitting smoking for people who continue to smoke after their diagnosis of coronary heart disease or stroke?
2. Is there a relationship between quitting smoking and future heart attacks or strokes in those who smoke at the time of diagnosis of coronary heart disease or stroke?
3. Is there a relationship between the length of time a person has stopped smoking and future heart attacks or strokes in those who smoke at the time of diagnosis of coronary heart disease or stroke?
4. Is there a relationship between doctors’ quit smoking treatment and successful quitting of smoking in people diagnosed with incident coronary heart disease or stroke, and a relationship between treatment received and subsequent cardiovascular events?
How is the research being done?
We will use anonymous data from GP records, linked to records of hospital admissions and records of death to investigate the impact of quitting smoking on cardiovascular disease after the diagnosis of coronary heart disease or stroke. We will use statistical methods to make sure we control for other factors that may cause a person to have a second stroke or heart attack, like being older or having diabetes.
Chief Investigator
Angela Wu
Lead Applicant Organisation Name
Sponsor
University of Oxford
Location of research
University of Oxford
Date on which research approved
02-Aug-2021
Project reference ID
OX57
Generic ethics approval reference
18/EM/0400
Are all data accessed are in anonymised form?
Yes
Brief summary of the dataset to be released (including any sensitive data)
We will be using general practice (GP) and hospital data to support investigation into the impact of stopping smoking and secondary cardiovascular disease events. This will be determined by comparing CVD outcomes for people who continue versus stop smoking after their first cardiovascular disease event. We will define individuals with coronary heart disease or stroke based on diagnostic codes (called Readcodes and ICD codes) taken from GP and hospital electronic health records. We will obtain patient demographic data, health characteristics, diagnoses, emergency admissions to hospital through linked data with Hospital Episode Statistics, primary cause of death through linked data from the National Death Register, prescribed medications, and referrals.
Implications and Impact
We will be able to assess whether there is good evidence that people who stop smoking after their first heart attack or stroke, will have a different risk of experiencing future heart attacks or stroke when compared to people who continue to smoke. This has implications for the advice the public are given about their smoking and treatments to quit regarding cardiovascular disease treatment. This work may also inform clinicians how best to offer stop smoking support, and which methods provide the largest decrease in risk for secondary cardiovascular disease events.
Funding Source
British Heart Foundation
Public Benefit Statement
Research Team
Angela Wu, Nuffield Department of Primary Healthcare Sciences, University of Oxford
Professor Julia Hippisley-Cox, Nuffield Department of Primary Healthcare Sciences, University of Oxford
Professor Paul Aveyard, Nuffield Department of Primary Healthcare Sciences, University of Oxford
Dr Jamie Hartmann-Boyce, Nuffield Department of Primary Healthcare Sciences, University of Oxford
Dr Nicola Lindson, Nuffield Department of Primary Healthcare Sciences, University of Oxford
Approval Letter
Access Type
Trusted Research Environment (TRE)