Abstract
BackgroundPrevious estimates for the prevalence of musculoskeletal conditions (MSK) and chronic pain in Australia have been based on self-report. We aimed to determine the prevalence and distribution of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis and current consultations for chronic pain among adults attending Australian general practice, and describe their distribution according to sociodemographic characteristics and presence of co-morbidities.MethodsWe investigated 1,501,267 active adult patients (57.6% females; 22.5% ≥65y) evaluated between 2013 and 2016 and included in the MedicineInsight database (a National Prescribing Service MedicineWise program), a large general practice data program that extracts longitudinal de-identified electronic medical record data from ‘active’ patients in over 550 practices. Three main groups of outcomes were investigated: 1) “prevalence” of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies, and/or rheumatoid arthritis between 2000 and 2016; 2) “current” diagnosis/encounter for the same conditions occurring between 2013 and 2016, and; 3) “current” consultations for chronic pain of any type occurring between 2013 and 2016.ResultsThe combined “prevalence” of the investigated MSK (diagnosis between 2000 and 2016) among adults attending Australian general practice was 16.8% (95%CI 15.9;17.7) with 21.3% (95%CI 20.2;22.4) of the sample consulting for chronic pain between 2013 and 2016. The investigated MSK with the highest “prevalence” were arthritis (9.5%) and chronic back pain (6.7%). Patients with some of these MSK attended general practices more frequently than those without these conditions (median 2.0 and 1.0 contacts/year, respectively). The “prevalence” of the investigated MSK and “current” consultations for chronic pain increased with age, especially in women, but chronic pain remained stable at 22% for males aged > 40 years. The investigated MSK and chronic pain were more frequent among those in lower socioeconomic groups, veterans, Aboriginal and Torrent Strait Islanders, current and ex-smokers, and patients with chronic obstructive pulmonary disease or heart failure.ConclusionsThe investigated MSK are more frequent among lower socioeconomic groups and the elderly. Based on information collected from adults attending Australian general practices, MedicineInsight provided similar estimates to those obtained from population-based studies, with the advantage of being based on medical diagnosis and including a national sample.
Highlights
Previous estimates for the prevalence of musculoskeletal conditions (MSK) and chronic pain in Australia have been based on self-report
Based on information collected from adults attending Australian general practices, MedicineInsight provided similar estimates to those obtained from population-based studies, with the advantage of being based on medical diagnosis and including a national sample
Increasing the scope and number of quality improvement activties has been recognised as being important for the Australian health care system and so the National Prescribing Service (NPS) MedicineWise was funded in 2011 to periodically collect longitudinal clinical and prescribing data from Australian general practices through MedicineInsight [17]. Utilising this large ongoing dataset, we aimed to investigate the prevalence of some MSK conditions and consultations for chronic pain among adults attending Australian general practices, describe their distribution according to patients’ sociodemographic characteristics and examine associations with other chronic non-communicable diseases (NCDs)
Summary
Previous estimates for the prevalence of musculoskeletal conditions (MSK) and chronic pain in Australia have been based on self-report. According to the Australian Institute of Health and Welfare (AIHW) and the National Health Survey (NHS), in 2011 they affected 28% of Australian adults (6.1 million) [6] Due to their chronicity and impact on health status and quality of life, they represent the fourth most expensive group of diseases in Australia, accounting for 9% of total health-care expenditure related to hospitalisations, out-of-hospital health care, and prescribed medications (approximately AUD$5.7 billion of the AUD$65 billion spent for all diseases) [7]. A few surveys have used self-reported data to investigate the prevalence of these conditions among Australian adults [6, 9, 10], while the Bettering the Evaluation and Care of Health (BEACH) program reported encounter rates and medication use for MSK and chronic pain in adults attending a random sample of Australian general practices [11, 12]. Studies on this topic using nationally representative samples and based on medical diagnosis are scarce in the scientific literature [3,4,5, 13]
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