Musculoskeletal condition primary care consultation prevalence in Staffordshire and Stoke-on-Trent: a seven-year health record analysis from the MIDAS-GP study

Abstract

Abstract Background and objectives Musculoskeletal (MSK) conditions place a significant burden on individuals and healthcare systems. The MIDAS-GP study collected anonymised electronic health record (EHR) data from MSK primary care consulters in Staffordshire and Stoke-on-Trent, United Kingdom. This retrospective EHR analysis aimed to 1) characterise this cohort of individuals, 2) to explore MSK condition consultation rates and frequent attender rates over time, between practices, and between MSK pain sites and 3) explore inequalities in MSK primary care frequent attender rates between cohort sub-groups. Methods We extracted EHR data of all adult MSK consulters in 30 GP practices in one English region over seven years. Consultation prevalence was reported per 1,000 of the registered adult population for each GP practice, based on the number of unique consulters in six-monthly time windows. Frequent attendance was defined as a consulter who had ≥ 5 consultations in the six months after their index consultation. Variation in frequent attender rates was reported crudely and using a fixed-effect regression model to evaluate their association with patient-level covariates. Results Between July 2016-June 2023, there were 768,870 MSK primary care appointments by 148,708 unique MSK consulters in the 30 GP practices that participated in the study. The mean six-month consultation prevalence was 126.18 per 1,000 of the registered adult population, although this started much higher in 2016, fell rapidly during the COVID-19 pandemic, with substantial variation in recovery by 2023. Overall, MSK frequent attender rates were 8.32%, accounting for around 25% of total MSK appointments. Frequent attenders were more likely to be older in age, female, and from less deprived areas. Discussion/conclusion This study represents the first reporting of a regional longitudinal dataset and complements national epidemiology by identifying areas of local variation in consultation and frequent attender rates. Future work should seek to understand what patient and practice-level factors are limiting access to primary care services both regionally and nationally, and seek to optimise the community-based outreach programmes to improve healthcare access.