Low back pain and osteoarthritis are common, painful conditions. They have a significant impact on the health of the population, reducing quality of life and causing difficulties with daily activities and paid work. Public Health England, the NHS, and Versus Arthritis, have recognised that there is a need for more accurate, up-to-date information on the scale of the problems due to arthritis. Doing new surveys on a regular basis is expensive and these often suffer from low or biased response rates. Using routinely collected information from healthcare contacts to estimate the numbers of people presenting to primary care with low back pain and osteoarthritis (and comparing these numbers between rich and poor neighbourhoods) can provide useful information to local, regional, and national policymakers and healthcare providers. In previous research studies of CPRD data we have estimated the numbers of people presenting with osteoarthritis each year. Our proposal is to update these estimates for the period 2000-2019, extend our analyses for the first time to cover low back pain, and to forecast future consultation rates of these conditions to the year 2030. We will look at how sensitive our findings are to different assumptions that we make about how these conditions are defined. We will present our findings to Public Health England and other stakeholders as part of an ongoing effort to raise awareness of these musculoskeletal conditions and identify new population indicators for ongoing monitoring as part of a wider strategy to promote better and co-ordinated action to prevent and manage these conditions.
Musculoskeletal disorders are the most common limiting long-term conditions in the UK, accounting for an estimated 22% of total morbidity burden in England and 12-14% of all primary care consultations in people aged 15 years and over. The rate at which patients present to primary care with these conditions is a potentially useful indicator of population health and healthcare demand.
Building on our prior studies, we will estimate the annual consultation incidence and prevalence of low back pain and osteoarthritis for the period 2000 to 2019. A series of sensitivity analyses will explore the impact of case definition and including secondary care diagnoses. We will then use Bayesian age-period-cohort methods to generate future projected estimates for the period 2020 to 2030. Finally, we will explore inequalities in the rate of presentation of these conditions to primary care by comparing the consultation incidence and prevalence estimates by area-level deprivation.
Annual consultation incidence and prevalence of osteoarthritis and low back pain
George Peat - Chief Investigator - Keele University
Dahai Yu - Corresponding Applicant - Keele University
James Bailey - Collaborator - Keele University
John Edwards - Collaborator - Keele University
Kelvin Jordan - Collaborator - Keele University
Matthew Missen - Collaborator - Keele University
Ross Wilkie - Collaborator - Keele University
HES Admitted Patient Care;Patient Level Index of Multiple Deprivation