Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases

Dahai Yu; Matthew Missen; Kelvin P. Jordan; John J. Edwards; James Bailey; Ross Wilkie; Justine Fitzpatrick; Nuzhat Ali; Paul Niblett; George Peat

doi:10.2147/CLEP.S337323

Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases

Dahai Yu^*, Matthew Missen, Kelvin P. Jordan, John J. Edwards, James Bailey, Ross Wilkie, Justine Fitzpatrick, Nuzhat Ali, Paul Niblett, George Peat

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: To compare estimates of annual person-consulting incidence and prevalence of low back pain (LBP) and osteoarthritis for two national English electronic health record databases (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD). Patients and Methods: Retrospective, population-based, longitudinal cohort study. LBP and osteoarthritis cases were defined using established codelists in people aged ≥15 and ≥45 years, respectively. Incident cases were new recorded cases in a given calendar year with no relevant consultation in the previous 3 years (denominator = exact person-time in the same calendar year for the at-risk population). Prevalent cases were individuals with ≥1 consultation for the condition of interest recorded in a given calendar year, irrespective of prior consultations for the same condition (denominator = all patients with complete registration history in the previous 3 years). We estimated age-sex standardised incidence and annual (12-month period) prevalence for both conditions in 2000–2019, overall, and by sex, age group, and region. Results: Standardised incidence and prevalence of LBP from Aurum were lower than those from GOLD until 2014, after which estimates were similar. Both databases showed recent declines in incidence and prevalence of LBP: declines began earlier in GOLD (after 2012–2014) than Aurum (after 2014–2015). Standardised incidence (after 2011) and prevalence of osteoarthritis (after 2003) were higher in Aurum than GOLD and showed different trends: incidence and prevalence were stable or increasing in Aurum, decreasing in GOLD. Stratified estimates in CPRD Aurum suggested consistently higher occurrence among women, older age groups, and those living in the north of England. Conclusion: Comparative analyses of two English databases produced conflicting estimates and trends for two common musculos-keletal conditions. Aurum estimates appeared more consistent with external sources and may be useful for monitoring population musculoskeletal health and healthcare demand, but they remain sensitive to analytic decisions and data quality.

Original language	English
Pages (from-to)	179-189
Number of pages	11
Journal	Clinical Epidemiology
Volume	14
DOIs	https://doi.org/10.2147/CLEP.S337323
Publication status	Published - 2022
Externally published	Yes

Bibliographical note

Funding Information:
This study is based on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare Products Regulatory Agency. The data are provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone. This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands).

Funding Information:
This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands).

Publisher Copyright:
© 2022 Yu et al.

Keywords

Electronic health records
Epidemiologic methods
Low back pain
Osteoarthritis
Primary care
musculoskeletal

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10.2147/CLEP.S337323

Cite this

Yu, D., Missen, M., Jordan, K. P., Edwards, J. J., Bailey, J., Wilkie, R., Fitzpatrick, J., Ali, N., Niblett, P., & Peat, G. (2022). Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases. Clinical Epidemiology, 14, 179-189. https://doi.org/10.2147/CLEP.S337323

@article{f67b5856fcc44f8ab3fd049c20e14e7d,

title = "Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases",

abstract = "Purpose: To compare estimates of annual person-consulting incidence and prevalence of low back pain (LBP) and osteoarthritis for two national English electronic health record databases (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD). Patients and Methods: Retrospective, population-based, longitudinal cohort study. LBP and osteoarthritis cases were defined using established codelists in people aged ≥15 and ≥45 years, respectively. Incident cases were new recorded cases in a given calendar year with no relevant consultation in the previous 3 years (denominator = exact person-time in the same calendar year for the at-risk population). Prevalent cases were individuals with ≥1 consultation for the condition of interest recorded in a given calendar year, irrespective of prior consultations for the same condition (denominator = all patients with complete registration history in the previous 3 years). We estimated age-sex standardised incidence and annual (12-month period) prevalence for both conditions in 2000–2019, overall, and by sex, age group, and region. Results: Standardised incidence and prevalence of LBP from Aurum were lower than those from GOLD until 2014, after which estimates were similar. Both databases showed recent declines in incidence and prevalence of LBP: declines began earlier in GOLD (after 2012–2014) than Aurum (after 2014–2015). Standardised incidence (after 2011) and prevalence of osteoarthritis (after 2003) were higher in Aurum than GOLD and showed different trends: incidence and prevalence were stable or increasing in Aurum, decreasing in GOLD. Stratified estimates in CPRD Aurum suggested consistently higher occurrence among women, older age groups, and those living in the north of England. Conclusion: Comparative analyses of two English databases produced conflicting estimates and trends for two common musculos-keletal conditions. Aurum estimates appeared more consistent with external sources and may be useful for monitoring population musculoskeletal health and healthcare demand, but they remain sensitive to analytic decisions and data quality.",

keywords = "Electronic health records, Epidemiologic methods, Low back pain, Osteoarthritis, Primary care, musculoskeletal",

author = "Dahai Yu and Matthew Missen and Jordan, {Kelvin P.} and Edwards, {John J.} and James Bailey and Ross Wilkie and Justine Fitzpatrick and Nuzhat Ali and Paul Niblett and George Peat",

note = "Funding Information: This study is based on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare Products Regulatory Agency. The data are provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone. This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands). Funding Information: This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands). Publisher Copyright: {\textcopyright} 2022 Yu et al.",

year = "2022",

doi = "10.2147/CLEP.S337323",

language = "English",

volume = "14",

pages = "179--189",

journal = "Clinical Epidemiology",

issn = "1179-1349",

publisher = "Dove Medical Press",

}

Yu, D, Missen, M, Jordan, KP, Edwards, JJ, Bailey, J, Wilkie, R, Fitzpatrick, J, Ali, N, Niblett, P & Peat, G 2022, 'Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases', Clinical Epidemiology, vol. 14, pp. 179-189. https://doi.org/10.2147/CLEP.S337323

TY - JOUR

T1 - Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019

T2 - Comparative Estimates from Two Clinical Practice Databases

AU - Yu, Dahai

AU - Missen, Matthew

AU - Jordan, Kelvin P.

AU - Edwards, John J.

AU - Bailey, James

AU - Wilkie, Ross

AU - Fitzpatrick, Justine

AU - Ali, Nuzhat

AU - Niblett, Paul

AU - Peat, George

N1 - Funding Information: This study is based on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare Products Regulatory Agency. The data are provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone. This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands). Funding Information: This work was supported by funding from Public Health England. KPJ is also supported by matched funding awarded to the NIHR Applied Research Collaboration (West Midlands). Publisher Copyright: © 2022 Yu et al.

PY - 2022

Y1 - 2022

N2 - Purpose: To compare estimates of annual person-consulting incidence and prevalence of low back pain (LBP) and osteoarthritis for two national English electronic health record databases (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD). Patients and Methods: Retrospective, population-based, longitudinal cohort study. LBP and osteoarthritis cases were defined using established codelists in people aged ≥15 and ≥45 years, respectively. Incident cases were new recorded cases in a given calendar year with no relevant consultation in the previous 3 years (denominator = exact person-time in the same calendar year for the at-risk population). Prevalent cases were individuals with ≥1 consultation for the condition of interest recorded in a given calendar year, irrespective of prior consultations for the same condition (denominator = all patients with complete registration history in the previous 3 years). We estimated age-sex standardised incidence and annual (12-month period) prevalence for both conditions in 2000–2019, overall, and by sex, age group, and region. Results: Standardised incidence and prevalence of LBP from Aurum were lower than those from GOLD until 2014, after which estimates were similar. Both databases showed recent declines in incidence and prevalence of LBP: declines began earlier in GOLD (after 2012–2014) than Aurum (after 2014–2015). Standardised incidence (after 2011) and prevalence of osteoarthritis (after 2003) were higher in Aurum than GOLD and showed different trends: incidence and prevalence were stable or increasing in Aurum, decreasing in GOLD. Stratified estimates in CPRD Aurum suggested consistently higher occurrence among women, older age groups, and those living in the north of England. Conclusion: Comparative analyses of two English databases produced conflicting estimates and trends for two common musculos-keletal conditions. Aurum estimates appeared more consistent with external sources and may be useful for monitoring population musculoskeletal health and healthcare demand, but they remain sensitive to analytic decisions and data quality.

AB - Purpose: To compare estimates of annual person-consulting incidence and prevalence of low back pain (LBP) and osteoarthritis for two national English electronic health record databases (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD). Patients and Methods: Retrospective, population-based, longitudinal cohort study. LBP and osteoarthritis cases were defined using established codelists in people aged ≥15 and ≥45 years, respectively. Incident cases were new recorded cases in a given calendar year with no relevant consultation in the previous 3 years (denominator = exact person-time in the same calendar year for the at-risk population). Prevalent cases were individuals with ≥1 consultation for the condition of interest recorded in a given calendar year, irrespective of prior consultations for the same condition (denominator = all patients with complete registration history in the previous 3 years). We estimated age-sex standardised incidence and annual (12-month period) prevalence for both conditions in 2000–2019, overall, and by sex, age group, and region. Results: Standardised incidence and prevalence of LBP from Aurum were lower than those from GOLD until 2014, after which estimates were similar. Both databases showed recent declines in incidence and prevalence of LBP: declines began earlier in GOLD (after 2012–2014) than Aurum (after 2014–2015). Standardised incidence (after 2011) and prevalence of osteoarthritis (after 2003) were higher in Aurum than GOLD and showed different trends: incidence and prevalence were stable or increasing in Aurum, decreasing in GOLD. Stratified estimates in CPRD Aurum suggested consistently higher occurrence among women, older age groups, and those living in the north of England. Conclusion: Comparative analyses of two English databases produced conflicting estimates and trends for two common musculos-keletal conditions. Aurum estimates appeared more consistent with external sources and may be useful for monitoring population musculoskeletal health and healthcare demand, but they remain sensitive to analytic decisions and data quality.

KW - Electronic health records

KW - Epidemiologic methods

KW - Low back pain

KW - Osteoarthritis

KW - Primary care

KW - musculoskeletal

UR - http://www.scopus.com/inward/record.url?scp=85125044288&partnerID=8YFLogxK

U2 - 10.2147/CLEP.S337323

DO - 10.2147/CLEP.S337323

M3 - Article

AN - SCOPUS:85125044288

SN - 1179-1349

VL - 14

SP - 179

EP - 189

JO - Clinical Epidemiology

JF - Clinical Epidemiology

ER -

Trends in the Annual Consultation Incidence and Prevalence of Low Back Pain and Osteoarthritis in England from 2000 to 2019: Comparative Estimates from Two Clinical Practice Databases

Abstract

Bibliographical note

Keywords

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