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Completeness of maternal smoking status recording during pregnancy in United Kingdom primary care data

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posted on 2016-05-11, 15:32 authored by Nafeesa N. Dhalwani, Laila J. Tata, Tim Coleman, Kate M. Fleming, Lisa Szatkowski
BACKGROUND: Given the health impacts of smoking during pregnancy and the opportunity for primary healthcare teams to encourage pregnant smokers to quit, our primary aim was to assess the completeness of gestational smoking status recording in primary care data and investigate whether completeness varied with women's characteristics. As a secondary aim we assessed whether completeness of recording varied before and after the introduction of the Quality and Outcomes Framework (QOF). METHODS: In The Health Improvement Network (THIN) database we calculated the proportion of pregnancies ending in live births or stillbirths where there was a recording of maternal smoking status for each year from 2000 to 2009. Logistic regression was used to assess variation in the completeness of maternal smoking recording by maternal characteristics, before and after the introduction of QOF. RESULTS: Women had a record of smoking status during the gestational period in 28% of the 277,552 pregnancies identified. In 2000, smoking status was recorded in 9% of pregnancies, rising to 43% in 2009. Pregnant women from the most deprived group were 17% more likely to have their smoking status recorded than pregnant women from the least deprived group before QOF implementation (OR 1.17, 95% CI 1.10-1.25) and 42% more likely afterwards (OR 1.42, 95% CI 1.37-1.47). A diagnosis of asthma was related to recording of smoking status during pregnancy in both the pre-QOF (OR 1.63, 95% CI 1.53-1.74) and post-QOF periods (OR 2.08, 95% CI 2.02-2.15). There was no association between having a diagnosis of diabetes and recording of smoking status during pregnancy pre-QOF however, post-QOF diagnosis of diabetes was associated with a 12% increase in recording of smoking status (OR 1.12, 95% CI 1.05-1.19). CONCLUSION: Recording of smoking status during pregnancy in primary care data is incomplete though has improved over time, especially after the implementation of the QOF, and varies by maternal characteristics and QOF-incentivised morbidities.

Funding

NND is supported by a University of Nottingham International Research Excellence Scholarship and the National Institute for Health Research (NIHR). This article presents independent research funded by the NIHR under its Programme Grants for Applied Research Programme (reference RP-PG 0109-10020). The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. NND, TC and LS are members of the UK Centre for Tobacco Control Studies (UKCTCS), a UKCRC Public Health Research Centre of Excellence. The UKCTCS receives core funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council and the Department of Health under auspices of the UK Clinical Research Collaboration.

History

Citation

PLoS One, 2013, 8 (9), pp. e72218

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine

Version

  • VoR (Version of Record)

Published in

PLoS One

Publisher

Public Library of Science

eissn

1932-6203

Acceptance date

2013-07-08

Copyright date

2013

Available date

2016-05-11

Publisher version

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0072218

Language

en

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