Incidence and management of Lyme disease: a Scottish general practice retrospective study.

Abstract

The true burden of Lyme disease in primary care in Scotland is unknown. Epidemiological data is currently based on laboratory confirmed reports as there is no mandatory reporting of clinical cases AIM: To analyse data from general practice in NHS Highland (North) over a six year period to assess the incidence and management of Lyme disease in primary care. This was a retrospective descriptive study. Study data was extracted from all 63 general practices within NHS Highland (North) from 2017 to 2022. Lyme disease consultations were identified via Lyme-related clinical read codes, borrelia test requests, free text 'tags' and/or Lyme disease antibiotic scripts. Using read codes to identify patients with Lyme disease/ suspected Lyme disease gave an estimated average annual incidence of 124/100,000 population, which was 2.1-fold more than those based on laboratory confirmed reports only. Incidence figures increased to 5.2-fold more (362/100,000 population) when those patients with Lyme disease/ suspected Lyme disease (identified via readcodes, laboratory test requests and free text 'tags') who were given antibiotic treatment were taken into account. Local 'hotspots' of infection were identified. Analysis of the antibiotic data indicates that antibiotic prescribing in NHS Highland largely follows NICE guidelines. This data analysis pathway can, and should, be rolled out to assess the incidence and management of Lyme disease in primary care throughout the whole of Scotland to allow appropriate resources to be allocated.