Analysis reveals true MSK burden

An analysis of GP visits sheds light on the real-life burden of musculoskeletal (MSK) disease on the healthcare system, finding one in 10 adults have osteoarthritis.

The study draws on the de-identified data of over 1.5 million adult patients who attended over 550 general practices across Australia between 2000 and 2016, setting it apart from other research on MSK prevalence rates which are largely informed by self-reported surveys, the authors point out.

They found almost 17% of patients attending general practice had MSK disease, with arthritis the most common (9.5%) followed by chronic back pain (6.7%).

Some 1.6% had gout, 1.2 % had osteoporosis, 1.1 % had spondyloarthropathies and 0.9% had rheumatoid arthritis.

The total burden of MSK disease eats up 9% of health expenditure each year, totalling approximately $5.7 billion.

There was variation in the distribution of arthritis and chronic back pain according to age and sex, with chronic back pain between 20% to 53% more common in men aged 20-49 than in women of the same age.

The figures revealed that arthritis rates were similar in both genders in the younger years but after the age of 50 women were 29% more likely to have the condition than men.

MSK disease was more common in the elderly and in those in lower socioeconomic groups, affecting 21.7% of healthcare or pension card holders and 24.1% of Department of Veterans Affairs card holders compared to 13.3% of those without.

Disease was also more common in smokers, with 20.5% diagnosed with a MSK condition compared to 16.8% of non-smokers.

The study also found marked variation between the states, the widest variation between Tasmania (19.4) and the Northern Territory (10.2%).

This something that has not been reported before in Australia and is “difficult to explain”, wrote David Alejandro Gonzalez-Chica and colleagues in BMC Musculoskeletal Disorders.

However it may relate to variation in access to general practice – notoriously worse in non-urban areas – and the levels at which GPs record the reasons for consultation.

Prevalence of MSK is also lower in remote Australia (14.6%) compared to major cities (16.4%), according to the findings.

The authors noted that their prevalence rates – drawn from Medicine Insight dataset – are similar to what has been reported in previous studies, however their data has the advantage of being based on medical diagnosis and a national sample.

This is something which is “scarce in the scientific literature”, they write, as most other research on the topic has been based on self-reported surveys, aside from research using the Bettering the Evaluation and Care of Health (BEACH) program which uses data from a random sample of general practices.

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