There have been few if any studies of people living in care homes using primary care electronic health records. People aged 80 years and over represent the most rapidly growing sector of the population in the UK. It is therefore increasingly important to understand the health and care needs of this group. We previously conducted research in Clinical Practice Research Datalink (CPRD) GOLD into ageing but we were unable to determine whether CPRD GOLD patients were living in their own homes. However, we now find that a substantial number of patients in CPRD Aurum are recorded as receiving care home or nursing home care. This research therefore aims to describe this group of patients in more detail. We will work out what percent of CPRD Aurum patients are living in care homes, looking at men and women, different age groups and changes over time. We will compare care home residents with other CPRD patients of the same age and sex, looking for differences in the level of frailty, the amount of associated health conditions, and the number with dementia. We will evaluate the mortality of care home residents in comparison with the general population in CPRD. Finally, we will evaluate Covid19 diagnoses during 2020. This information will be useful for designing future studies of the care home population in CPRD.
The CPRD Aurum database offers an opportunity to conduct epidemiological studies of care home residents. The project aims to provide initial descriptive data for the care home population in CPRD Aurum. The research aims to evaluate the proportion of patients in CPRD Aurum that are living in care homes and nursing homes; to describe their characteristics in terms of frailty status, comorbidity, dementia diagnoses and polypharmacy; to evaluate Covid19 diagnoses in care home residents; and to evaluate all-cause mortality in care home residents. We will conduct a cohort study of patients recorded as living in a care home between 2006 and 2020. We will select age, sex and general practice matched controls. For care home patients and controls we will evaluate frailty status using the eFrailty index, comorbidity using the Charlson Index, dementia diagnoses, all-cause mortality, drug utilisation and polypharmacy and Covid-19 diagnosis. Conditional logistic regression will be employed to compare care home patients and comparators. Survival analysis methods will be employed to evaluate the prognosis of care home patients in terms of all-cause mortality. We will evaluate whether mortality in the care home population has increased since the pandemic started in the UK on 29th January 2020 by using an interrupted time series design. We hope that the research will provide evidence that will help to confirm whether or not CPRD Aurum patients are resident in care homes. The research will also provide basic descriptive data for this population, which can be studied further in future projects.
Whether living in a care home or nursing home. Frailty status using the eFrailty Index. Comorbidity using the Charlson Index. Dementia diagnoses. All-cause mortality. Drug utilisation and polypharmacy. Covid-19 diagnosis.
Martin Gulliford - Chief Investigator - King's College London (KCL)
Martin Gulliford - Corresponding Applicant - King's College London (KCL)
Emma Rezel-Potts - Collaborator - King's College London (KCL)