Dr. Dahai Yu d.yu@keele.ac.uk
Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013
Yu, Dahai; Jordan, Kelvin; Bedson, John; Englund, Martin; Blyth, Fiona; Turkiewicz, Aleksandra; Prieto-Alhambra, Daniel; Peat, George
Authors
Kelvin Jordan k.p.jordan@keele.ac.uk
John Bedson
Martin Englund
Fiona Blyth
Aleksandra Turkiewicz
Daniel Prieto-Alhambra
George Peat
Abstract
Objective
To determine recent trends in the rate and management of new cases of OA presenting to primary healthcare using UK nationally representative data.
Methods
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.
Results
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).
Conclusion
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.
Citation
Yu, D., Jordan, K., Bedson, J., Englund, M., Blyth, F., Turkiewicz, A., …Peat, G. (2017). Population trends in the incidence and initial management of osteoarthritis: age-period-cohort analysis of the Clinical Practice Research Datalink, 1992–2013. Rheumatology, 56(11), 1902-1917. https://doi.org/10.1093/rheumatology/kex270
Journal Article Type | Article |
---|---|
Acceptance Date | Jun 9, 2017 |
Online Publication Date | Aug 4, 2017 |
Publication Date | Aug 4, 2017 |
Journal | Rheumatology |
Print ISSN | 1462-0324 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Volume | 56 |
Issue | 11 |
Pages | 1902-1917 |
DOI | https://doi.org/10.1093/rheumatology/kex270 |
Keywords | osteoarthritis; incidence; primary care; analgesics |
Publisher URL | https://academic.oup.com/rheumatology/article/doi/10.1093/rheumatology/kex270/4065207/Population-trends-in-the-incidence-and-initial |
Files
D Yu - Population Trends.pdf
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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