Table 1.
Descriptive characteristics and covariate distributionsa in musculoskeletal consulter cohorts, 2016–2017
| MSK consultersb aged 35+ years, 2016–2017 |
Low back pain consulters aged 35+ years, 2016–2017 |
Shoulder pain consulters aged 35+ years, 2016–2017 |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MSK health indicator(s) of interest | % with high impact chronic pain, mean MSK-HQ score, mean EQ-5D-5L score |
% with moderate-to-severe chronic low back pain |
% with moderate-to-severe chronic shoulder pain |
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| Data source | PRELIM Survey-EHR | CPRD | PRELIM Survey-EHR | CPRD | PRELIM Survey-EHR | CPRD | ||||||||
| n | 3710 | 49 788 | 1046 | 15 153 | 604 | 9690 | ||||||||
| Age, median (IQR), years | 67 (57–75) | 61 (52–72) | 65 (55–74) | 59 (49–71) | 66 (57–74) | 61 (52–72) | ||||||||
| Female |
2191 (59) |
28 880 (58) |
620 (59) |
8907 (59) |
346 (57) |
5564 (57) |
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| Index of multiple deprivation | ||||||||||||||
| Quintile 1 (most deprived) |
626 (17) |
6909 (14) |
185 (18) |
2524 (17) |
110 (18) |
1314 (14) |
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| Quintile 2 |
575 (15) |
7818 (16) |
157 (15) |
2630 (17) |
83 (14) |
1469 (15) |
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| Quintile 3 |
748 (20) |
8988 (18) |
211 (20) |
2813 (19) |
120 (20) |
1745 (18) |
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| Quintile 4 |
1184 (32) |
10 153 (20) |
328 (31) |
2949 (19) |
196 (33) |
1993 (21) |
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| Quintile 5 (least deprived) |
630 (17) |
15 920 (32) |
165 (16) |
4237 (28) |
95 (16) |
3169 (33) |
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| MSK site-specific pain/condition | ||||||||||||||
| Neck pain |
897 (24) |
11 487 (23) |
211 (20) |
2465 (16) |
120 (20) |
1798 (19) |
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| Shoulder pain |
1129 (30) |
16 306 (33) |
221 (21) |
3044 (20) |
— | — | ||||||||
| Back pain |
1793 (48) |
25 559 (51) |
— | — |
199 (33) |
3603 (37) |
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| Hip pain |
847 (23) |
7583 (15) |
199 (19) |
2054 (14) |
87 (14) |
1242 (13) |
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| Knee pain |
1574 (42) |
21 876 (44) |
293 (28) |
3668 (24) |
192 (32) |
2597 (27) |
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| Hand pain |
1008 (27) |
9483 (19) |
205 (20) |
1724 (11) |
125 (21) |
1258 (13) |
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| Osteoarthritis |
1445 (39) |
9894 (20) |
259 (25) |
1634 (11) |
189 (31) |
1337 (14) |
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| Time since 1st MSK consultation, median (IQR), days: median (IQR) | 1179 (483–1590) | 1053 (310–1549) | 1228 (518–1620) | 1,094 (323–1563) | 1,283 (552–1,629) | 1,066 (316–1,562) | ||||||||
| Time since last MSK consultation, median (IQR), days: median (IQR) | 132 (97–162) | 150 (66–253) | 131 (97–161) | 143 (59–245) | 136 (97–162) | 140 (59–240) | ||||||||
| Number of MSK consultations: , median (IQR) | 5 (2–9) | 3 (2–6) | 5 (3–10) | 3 (2–6) | 5 (3–10) | 4 (2–6) | ||||||||
| Any analgesic prescription | 3,051(82) | 36 048(72) | 877(84) | 11 983(79) | 485(80) | 6,828(71) | ||||||||
| Highest-level of analgesic prescription: | ||||||||||||||
| No analgesicsics | 659(18) | 13 740(28) | 169(16) | 3,170(21) | 119(20) | 2,862(30) | ||||||||
| Basicsic analgesicsics | 561(15) | 5,445(11) | 113(11) | 1,101(7) | 82(14) | 1,055(11) | ||||||||
| Weak analgesicsics | 420(11) | 4,469(9) | 115(11) | 1,326(9) | 69(11) | 808(8) | ||||||||
| Moderate analgesicsics | 424(11) | 3,834(8) | 127(12) | 1,264(8) | 67(11) | 743(8) | ||||||||
| Strong/very strong analgesicsics | 1,646(44) | 22 300(45) | 522(50) | 8,292(55) | 267(44) | 4,222(44) | ||||||||
| NSAIDsS prescription | 1,331(35) | 25 878(52) | 428(41) | 8,637(57) | 223(37) | 5,270(54) | ||||||||
| Antidepressant prescription | 1,396(37) | 28 615(58) | 465(45) | 9,319(62) | 240(40) | 5,578(58) | ||||||||
| Sedative prescription | 221(6) | 6,446(13) | 73(7) | 2,158(14) | 41(7) | 1,322(14) | ||||||||
| Muscle relaxant prescription | 51(1) | 8,582(17) | 24(2) | 3,717(25) | 5(1) | 1,530(16) | ||||||||
| Any MSK referral | 1,400(37) | 31 416(63) | 404(39) | 9,169(61) | 237(39) | 6,516(67) | ||||||||
| MSK X-ray | 2,107(56) | 19 160(38) | 492(47) | 5,919(39) | 339(56) | 1,468(15) | ||||||||
| MSK MRI | 121 (3) | 2745 (6) | 53 (5) | 1293 (9) | 19 (3) | 215 (2) | ||||||||
| MSK surgery | 527 (14) | 8179 (16) | 137 (13) | 1954 (13) | 68 (11) | 1943 (20) | ||||||||
| Joint injection | 308 (8) | 3847 (8) | 75 (7) | 1027 (7) | 76 (13) | 1144 (12) | ||||||||
| Fracture | 157 (4) | 3348 (7) | 49 (5) | 1006 (7) | 20 (3) | 622 (6) | ||||||||
| Impact on work (recorded fit-note) | 956 (25) | 4067 (8) | 326 (31) | 1408 (9) | 152 (25) | 782 (8) | ||||||||
| BMI | ||||||||||||||
| Healthy/underweight (<25 kg/m2) | 320 (9) | 11 022 (22) | 109 (10) | 3494 (23) | 69 (11) | 2191 (23) | ||||||||
| BMI not recorded | 535 (14) | 10 880 (22) | 150 (15) | 3325 (22) | 69 (11) | 2064 (21) | ||||||||
| Overweight (25–29.9 kg/m2) | 1603 (43) | 13 871 (28) | 642 (61) | 4163 (28) | 395 (65) | 2774 (29) | ||||||||
| Obese (≥30 kg/m2) | 1252 (34) | 14 074 (28) | 124 (12) | 4171 (28) | 71 (12) | 2661 (28) | ||||||||
| Smoking status | ||||||||||||||
| Non-smoker | 1435 (39) | 21 390 (43) | 351 (34) | 6120 (40) | 244 (40) | 4270 (44) | ||||||||
| Smoking status not recorded | 324 (9) | 5726 (12) | 254 (24) | 1669 (11) | 46 (8) | 1066 (11) | ||||||||
| Ex-smoker | 716 (19) | 14 257 (29) | 156 (15) | 4328 (29) | 114 (19) | 2765 (29) | ||||||||
| Current smoker | 1235 (32) | 8415 (17) | 285 (27) | 3036 (20) | 200 (33) | 1589 (16) | ||||||||
| Drinking status | ||||||||||||||
| Non-drinker/drinking status not recorded/ex-drinker | 1785 (48) | 2470(53) | 213 (20) | 8237 (54) | 116 (19) | 5120 (53) | ||||||||
| Current Drinker | 1925 (52) | 23 408 (47) | 833 (80) | 6916 (46) | 488 (81) | 4570 (47) | ||||||||
| Charlson Comorbidity Index (0-–37) | 0 (0–2) | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0 (0–1) | 0 (0–1) | ||||||||
| eFI score (0-–10): ), median (IQR) | 0.08 (0.06–0.14) | 0.06 (0.03–0.11) | 0.08 (0.06–0.14) | 0.06 (0.03–0.11) | 0.08 (0.03–0.14) | 0.06 (0.03–0.08) | ||||||||
| Anxiety or depression consultation | 751(20) | 10 736(22) | 253(24) | 3,759(25) | 118(20) | 2,123(22) | ||||||||
Data are n (%), unless otherwise stated. Mean MSK-HQ and Mean EQ-5D-5L are outcomes (indicators) were both derived from MSK consulter cohorts. aCovariates were defined within a 5-year look back period in each cohort members’ electronic health record (i.e. 60 months prior to 30 June 2017). bDefined as non-specific, non-inflammatory low back pain, neck pain, shoulder pain, hand/wrist pain, hip pain, knee pain or osteoarthritis. eFI: electronic frailty index; IQR: interquartile range; MSK: musculoskeletal.