Claire Burton c.burton@keele.ac.uk
The impact of the COVID-19 pandemic on referrals to musculoskeletal services from primary care and subsequent incidence of inflammatory rheumatic musculoskeletal disease: an observational study
Burton, Claire; Mallen, Christian; Mason, Kayleigh; Jordan, Kelvin; Welsh, Victoria; Bajpai, Ram; Bailey, James
Authors
Christian Mallen c.d.mallen@keele.ac.uk
Dr Kayleigh Mason k.mason@keele.ac.uk
Kelvin Jordan k.p.jordan@keele.ac.uk
Dr Victoria Welsh v.welsh@keele.ac.uk
Dr Ram Bajpai r.bajpai@keele.ac.uk
James Bailey j.bailey4@keele.ac.uk
Abstract
Objectives
To describe the impact of the COVID-19 pandemic upon referral patterns and incident diagnosis of inflammatory rheumatic and musculoskeletal diseases (iRMDs).
Methods
UK primary care data was used to describe referral patterns for patients with musculoskeletal conditions. Trends in referrals to musculoskeletal services and incident diagnoses of iRMDs (specifically rheumatoid arthritis (RA) and juvenile inflammatory arthritis (JIA)) were described using Joinpoint Regression and comparisons made between key pandemic time periods.
Results
The incidence of RA and JIA reduced by -13.3% and -17.4% per month respectively between January 2020 and April 2020, and then increased by 1.9% and 3.7% per month respectively between April 2020 and October 2021. The incidence of all diagnosed iRMDs was stable until October 2021. Referrals decreased between February 2020 and May 2020 by -16.8% per month from 4.8% to 2.4% in patients presenting with a musculoskeletal condition. After May 2020, referrals increased significantly (16.8% per month) to 4.5% in July 2020. Time from first musculoskeletal consultation to RA diagnosis, and referral to RA diagnosis increased in the early-pandemic period (rate ratio (RR) 1.11, 95%CI 1.07-1.15; RR 1.23, 95%CI 1.17-1.30) and remained consistently higher in the late-pandemic (RR 1.13, 95%CI 1.11-1.16; RR 1.27, 95%CI 1.23-1.32) periods respectively, compared to the pre-COVID-19 period.
Conclusion
Patients with underlying RA and JIA that developed during the pandemic may be yet to present, or be in the referral and/or diagnostic process. Clinicians should remain alert to this possibility and commissioners aware of these findings, enabling the appropriate planning and commissioning of services.
Citation
Burton, C., Mallen, C., Mason, K., Jordan, K., Welsh, V., Bajpai, R., & Bailey, J. (2023). The impact of the COVID-19 pandemic on referrals to musculoskeletal services from primary care and subsequent incidence of inflammatory rheumatic musculoskeletal disease: an observational study. Rheumatology Advances in Practice, 7(2), Article ARTN rkad044. https://doi.org/10.1093/rap/rkad044
Journal Article Type | Article |
---|---|
Acceptance Date | Apr 14, 2023 |
Online Publication Date | May 2, 2023 |
Publication Date | Apr 12, 2023 |
Publicly Available Date | Jun 20, 2023 |
Journal | RHEUMATOLOGY ADVANCES IN PRACTICE |
Print ISSN | 2514-1775 |
Electronic ISSN | 2514-1775 |
Publisher | Oxford University Press |
Peer Reviewed | Peer Reviewed |
Volume | 7 |
Issue | 2 |
Article Number | ARTN rkad044 |
DOI | https://doi.org/10.1093/rap/rkad044 |
Keywords | COVID-19; inflammatory rheumatic and musculoskeletal disease; disorders; electronic health-care record research |
Files
Rheumatology Advances in Practice - clean.docx
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Document
Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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