Musculoskeletal (MSK) pain is common in older adult populations. People with dementia and older adults without dementia report similar pain problems and have similar pain conditions, an example is the condition osteoarthritis. However, previous studies have shown differences in the recognition, assessment, and treatment of pain in those with dementia compared to those without dementia. These differences are linked with negative health outcomes in those with dementia, such as increased confusion, falls, and behavioural problems.
At present the majority of research on pain assessment and pain treatment between those with dementia and those without is focused on nursing home populations. Currently there is little information on whether these differences exist in community settings, even though most people with dementia live in their own homes and are treated for pain by their local GP. This study proposes to compare the consultations and treatments that people have for pain between older adults with and without dementia in a primary care community setting. The study will look to establish if differences exist between those with dementia and not, regarding their pain consultations and pain treatments.
Objective:
The objective of the project is to describe the epidemiology (prevalence, incidence) of MSK consultations in a cohort of people with dementia compared to a matched cohort, and to investigate the longitudinal development pattern of pain consultations and pain treatments in the dementia cohort compared to a matched cohort.
Methods:
We will identify people with a diagnosis of dementia registered with general practices in the Clinical Research Practice Datalink (CPRD) between 1997-2017. People with dementia will be compared to a year of birth, sex, and practice matched cohort with no evidence of dementia diagnosis.
Data Analysis:
A retrospective matched cohort design will be used to investigate the four aims of the project. Firstly, period prevalence and incidence rates of MSK pain consultations for the dementia cohort and matched cohort will be calculated and compared. In addition, the drug count and pattern of analgesic prescriptions will be explored for the dementia cohort compared to the matched cohort using regression analyses (multinomial and multiple). Finally, longitudinal analysis will be conducted from pre-to-post index date (dementia diagnosis or equivalent date for matched cohort) for both the dementia and matched cohorts to investigate MSK consultation frequency and analgesic prescription frequency using joinpoint regression.
Primary outcomes:
- Musculoskeletal consultation
- Analgesic prescriptions
John Bedson - Chief Investigator - Keele University
Laurna Bullock - Corresponding Applicant - Keele University
Laurna Bullock - Collaborator - Keele University
Paul Campbell - Collaborator - Keele University
Ying Chen - Collaborator - Keele University
Practice Level Index of Multiple Deprivation