Population trends in the incidence and initial management of osteoarthritis : age-period-cohort analysis of the Clinical Practice Research Datalink, 1992-2013
Yu, Dahai (Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK)
Jordan, Kelvin P.. (Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK)
Bedson, John (Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK)
Englund, Martin (Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA)
Blyth, Fiona (Concord Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia)
Turkiewicz, Aleksandra (Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden)
Prieto-Alhambra, Daniel (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Peat, George (Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK)
Universitat Autònoma de Barcelona

Data:	2017
Resum:	To determine recent trends in the rate and management of new cases of OA presenting to primary healthcare using UK nationally representative data. Using the Clinical Practice Research Datalink we identified new cases of diagnosed OA and clinical OA (including OA-relevant peripheral joint pain in those aged over 45 years) using established code lists. For both definitions we estimated annual incidence density using exact person-time, and undertook descriptive analysis and age-period-cohort modelling. Demographic characteristics and management were described for incident cases in each calendar year. Sensitivity analyses explored the robustness of the findings to key assumptions. Between 1992 and 2013 the annual age-sex standardized incidence rate for clinical OA increased from 29. 2 to 40. 5/1000 person-years. After controlling for period effects, the consultation incidence of clinical OA was higher for successive cohorts born after the mid-1950s, particularly women. In contrast, with the exception of hand OA, we observed no increase in the incidence of diagnosed OA: 8. 6/1000 person-years in 2004 down to 6. 3 in 2013. In 2013, 16. 4% of clinical OA cases had an X-ray referral. While NSAID prescriptions fell from 2004, the proportion prescribed opioid analgesia rose markedly (0. 1% of diagnosed OA in 1992 to 1. 9% in 2013). Rising rates of clinical OA, continued use of plain radiography and a shift towards opioid analgesic prescription are concerning. Our findings support the search for policies to tackle this common problem that promote joint pain prevention while avoiding excessive and inappropriate health care.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Osteoarthritis ; Incidence ; Primary care ; Analgesics
Publicat a:	Rheumatology, Vol. 56 (august 2017) , p. 1902-1917, ISSN 1462-0332

DOI: 10.1093/rheumatology/kex270
PMID: 28977564

16 p, 1.3 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Articles de recerca
Articles > Articles publicats