Trends in consultations and prescribing for rheumatic and musculoskeletal diseases : an electronic primary care records study
© The Authors..
BACKGROUND: Rheumatic and musculoskeletal diseases (RMDs) are common and generally managed in primary care through supported self-care, physiotherapy, analgesia, and specialist referral where indicated. The COVID-19 pandemic led to abrupt changes in primary care delivery, including moves to remote consulting, pauses on group-based self-care, and restricted referrals.
AIM: To describe how patterns of UK primary healthcare consultations and analgesic prescribing relating to RMDs changed during the COVID-19 pandemic.
DESIGN AND SETTING: Observational study using routinely collected national primary care electronic health record data from the Clinical Practice Research Datalink between 1 April 2017 and 1 October 2021.
METHOD: RMD and analgesic SNOMED-CT codes were derived through consensus and published work. Prevalent and incident RMD-related consultations were determined, and RMD consultations matched to prevalent and incident analgesia prescriptions. Joinpoint regression was used to describe trends over time.
RESULTS: Prevalent and incident RMD consultations steadily increased until March 2020 when a substantial drop occurred as pandemic- related restrictions were introduced; levels had not recovered to pre-pandemic highs by October 2021. While incident and prevalent analgesic prescribing also reduced around March 2020, the proportion of patients with an RMD consultation prescribed any analgesic increased from 27.72% in February 2020 to 38.15% in April 2020, with increases across all analgesic groups. A higher proportion of strong opioid prescriptions was seen in the most deprived areas.
CONCLUSION: Pandemic-associated restrictions led to fewer primary care consultations and relative increases in analgesic prescribing, including strong opioids, for RMDs in the UK. Policymakers must consider the impact of these changes in future healthcare resource planning.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:73 |
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| Enthalten in: |
The British journal of general practice : the journal of the Royal College of General Practitioners - 73(2023), 736 vom: 18. Nov., Seite e858-e866 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Welsh, Victoria K [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesia |
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| Anmerkungen: |
Date Completed 30.10.2023 Date Revised 20.11.2023 published: Electronic-Print Citation Status MEDLINE |
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| doi: |
10.3399/BJGP.2022.0648 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Trends in consultations and prescribing for rheumatic and musculoskeletal diseases |b an electronic primary care records study |
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| 500 | |a Date Completed 30.10.2023 | ||
| 500 | |a Date Revised 20.11.2023 | ||
| 500 | |a published: Electronic-Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Authors. | ||
| 520 | |a BACKGROUND: Rheumatic and musculoskeletal diseases (RMDs) are common and generally managed in primary care through supported self-care, physiotherapy, analgesia, and specialist referral where indicated. The COVID-19 pandemic led to abrupt changes in primary care delivery, including moves to remote consulting, pauses on group-based self-care, and restricted referrals | ||
| 520 | |a AIM: To describe how patterns of UK primary healthcare consultations and analgesic prescribing relating to RMDs changed during the COVID-19 pandemic | ||
| 520 | |a DESIGN AND SETTING: Observational study using routinely collected national primary care electronic health record data from the Clinical Practice Research Datalink between 1 April 2017 and 1 October 2021 | ||
| 520 | |a METHOD: RMD and analgesic SNOMED-CT codes were derived through consensus and published work. Prevalent and incident RMD-related consultations were determined, and RMD consultations matched to prevalent and incident analgesia prescriptions. Joinpoint regression was used to describe trends over time | ||
| 520 | |a RESULTS: Prevalent and incident RMD consultations steadily increased until March 2020 when a substantial drop occurred as pandemic- related restrictions were introduced; levels had not recovered to pre-pandemic highs by October 2021. While incident and prevalent analgesic prescribing also reduced around March 2020, the proportion of patients with an RMD consultation prescribed any analgesic increased from 27.72% in February 2020 to 38.15% in April 2020, with increases across all analgesic groups. A higher proportion of strong opioid prescriptions was seen in the most deprived areas | ||
| 520 | |a CONCLUSION: Pandemic-associated restrictions led to fewer primary care consultations and relative increases in analgesic prescribing, including strong opioids, for RMDs in the UK. Policymakers must consider the impact of these changes in future healthcare resource planning | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 pandemic | |
| 650 | 4 | |a analgesia | |
| 650 | 4 | |a drug prescribing | |
| 650 | 4 | |a musculoskeletal diseases | |
| 650 | 4 | |a musculoskeletal pain | |
| 650 | 4 | |a primary care | |
| 650 | 7 | |a Analgesics |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Mason, Kayleigh J |e verfasserin |4 aut | |
| 700 | 1 | |a Bailey, James |e verfasserin |4 aut | |
| 700 | 1 | |a Bajpai, Ram |e verfasserin |4 aut | |
| 700 | 1 | |a Jordan, Kelvin P |e verfasserin |4 aut | |
| 700 | 1 | |a Mallen, Christian D |e verfasserin |4 aut | |
| 700 | 1 | |a Burton, Claire |e verfasserin |4 aut | |
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