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在英国初级保健中足部和踝关节疼痛的就诊情况:基于 CPRD 数据的人群队列研究。

Encounters for foot and ankle pain in UK primary care: a population-based cohort study of CPRD data.

机构信息

NIHR clinical academic training fellow, University of Southampton, and Department of Podiatry, Solent NHS Trust, Southampton, UK.

Faculty of Health Sciences, University of Southampton, Southampton, UK.

出版信息

Br J Gen Pract. 2019 Jun;69(683):e422-e429. doi: 10.3399/bjgp19X703817. Epub 2019 May 20.

Abstract

BACKGROUND

Older patients who have foot pain report variation in access to services to manage their foot health. To plan services it is essential to understand the scale and burden of foot pain that exists for GPs.

AIM

To provide UK-wide population-level data of the frequency of foot and/or ankle pain encounters recorded in general practice.

DESIGN AND SETTING

Population-based cohort design study using data drawn from the UK Clinical Practice Research Datalink (CPRD) from January 2010 to December 2013.

METHOD

All CPRD data were collected prospectively by participating GPs. The primary outcome was prevalence of GP encounters for foot and/or ankle pain, stratified by age, sex, and different subgroups of causes.

RESULTS

A foot and/or ankle pain encounter was recorded for 346 067 patients, and there was a total of 567 095 recorded encounters (mean per person 1.6, standard deviation [SD] 1.3). The prevalence of recorded encounters of foot and/or ankle pain was 2980 per 100 000 (3%). The number of patients with a recorded encounter of foot and/or ankle pain was 1820 per 100 000 (1.8%). Foot and/or ankle pain encounters were reported across all age groups (54.4% females), with those aged 71-80 years placing the greatest burden on GPs. The most common specified referrals were to orthopaedics ( = 36 881) and physiotherapy ( = 33 987), followed by podiatry ( = 25 980).

CONCLUSION

The burden of foot and/or ankle pain encounters recorded by GPs is not insubstantial, and spans all ages, with a high proportion of referrals to orthopaedics. The authors recommend further exploration of 'first-contact practitioners' for foot and/or ankle pain in general practice to alleviate the burden on GPs.

摘要

背景

有足部疼痛的老年患者报告在获得服务以管理其足部健康方面存在差异。为了规划服务,了解全科医生所管理的足部疼痛的规模和负担至关重要。

目的

提供英国范围内的足部和/或踝关节疼痛就诊记录的频率数据,这些数据来自全科实践。

设计和设置

这是一项基于人群的队列设计研究,使用了 2010 年 1 月至 2013 年 12 月期间从英国临床实践研究数据链(CPRD)中提取的数据。

方法

所有 CPRD 数据均由参与的全科医生前瞻性收集。主要结局是按年龄、性别和不同病因亚组分层的足部和/或踝关节疼痛就诊的发生率。

结果

记录了 346067 名患者的足部和/或踝关节疼痛就诊,共记录了 567095 次就诊(人均就诊次数为 1.6,标准差为 1.3)。记录的足部和/或踝关节疼痛就诊的发生率为 2980/100000(3%)。记录有足部和/或踝关节疼痛就诊的患者人数为 1820/100000(1.8%)。足部和/或踝关节疼痛就诊发生在所有年龄段(54.4%为女性),71-80 岁年龄组的患者给全科医生带来的负担最大。最常见的指定转诊科室为骨科(=36881)和物理治疗科(=33987),其次是足病科(=25980)。

结论

全科医生记录的足部和/或踝关节疼痛就诊的负担不小,且涵盖所有年龄段,其中很大一部分患者需要转诊至骨科。作者建议进一步探索全科医生对足部和/或踝关节疼痛的“第一接触医师”,以减轻全科医生的负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc21/6532799/a19e57421781/bjgpJun-2019-69-683-e422-OA-1.jpg

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