González-Chica David Alejandro, Vanlint Simon, Hoon Elizabeth, Stocks Nigel
Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, SA, Australia.
School of Public Health, The University of Adelaide, Adelaide, SA, Australia.
BMC Musculoskelet Disord. 2018 Jan 18;19(1):20. doi: 10.1186/s12891-018-1941-x.
Previous 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.
We 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.
The 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.
The 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.
此前对澳大利亚肌肉骨骼疾病（MSK）和慢性疼痛患病率的估计均基于自我报告。我们旨在确定在澳大利亚全科医疗就诊的成年人中关节炎、慢性背痛、痛风、骨质疏松症、脊柱关节病和类风湿关节炎的患病率及分布情况，以及当前慢性疼痛的就诊情况，并根据社会人口学特征和合并症的存在情况描述其分布。
我们调查了2013年至2016年间评估的1,501,267名成年活跃患者（女性占57.6%；65岁及以上者占22.5%），这些患者被纳入了MedicineInsight数据库（一项国家处方服务MedicineWise计划），这是一个大型全科医疗数据项目，从550多家医疗机构的“活跃”患者中提取纵向匿名电子病历数据。研究了三组主要结果：1）2000年至2016年间关节炎、慢性背痛、痛风、骨质疏松症、脊柱关节病和/或类风湿关节炎的“患病率”；2）2013年至2016年间出现的相同疾病的“当前”诊断/就诊情况；3）2013年至2016年间出现的任何类型慢性疼痛的“当前”就诊情况。
在澳大利亚全科医疗就诊的成年人中，所调查的肌肉骨骼疾病（2000年至2016年诊断）的综合“患病率”为16.8%（95%CI 15.9；17.7），2013年至2016年间有21.3%（95%CI 20.2；22.4）的样本因慢性疼痛就诊。“患病率”最高的所调查肌肉骨骼疾病是关节炎（9.5%）和慢性背痛（6.7%）。患有某些此类肌肉骨骼疾病的患者比未患这些疾病的患者更频繁地就诊于全科医疗（中位数分别为每年2.0次和1.0次就诊）。所调查的肌肉骨骼疾病的“患病率”和慢性疼痛的“当前”就诊率随年龄增加，尤其是在女性中，但40岁以上男性的慢性疼痛就诊率稳定在22%。所调查的肌肉骨骼疾病和慢性疼痛在社会经济地位较低的人群、退伍军人、原住民和托雷斯海峡岛民、当前吸烟者和既往吸烟者以及患有慢性阻塞性肺疾病或心力衰竭的患者中更为常见。
所调查的肌肉骨骼疾病在社会经济地位较低的人群和老年人中更为常见。基于从在澳大利亚全科医疗就诊的成年人中收集的信息，MedicineInsight提供的估计与基于人群的研究结果相似，其优势在于基于医学诊断且包括全国样本。
