Association of Polymyalgia Rheumatica With Socioeconomic Status in Primary Care: A Cross‐Sectional Observational Study

Hayward, Richard; Rathod, Trishna; Müller, Sara; Hider, Samantha L.; Roddy, Edward; Mallen, Christian

doi:10.1002/acr.22276

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…The highest incidence, 113 per 100 000 patients, previously reported was a study from the South West of England 4. Although the overall incidence rate we found is lower than this, our estimate for this region was slightly higher (124.1 (120.6, 127.6)).…”

Section: Discussioncontrasting

confidence: 74%

Incidence, prevalence and treatment burden of polymyalgia rheumatica in the UK over two decades: a population-based study

Partington

Müller

Helliwell

et al. 2018

Annals of the Rheumatic Diseases

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ObjectivePolymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease in older people. Contemporary estimates of the incidence and prevalence are lacking, and no previous study has assessed treatment patterns at a population level. This study aims to address this.MethodsWe extracted anonymised electronic medical records of patients over the age of 40 years from the Clinical Practice Research Datalink in the period 1990–2016. The absolute rate of PMR per 100 000 person-years was calculated and stratified by age, gender and calendar year. Incidence rate ratios were calculated using a Poisson regression model. Among persons with PMR, continuous and total duration of treatment with glucocorticoids (GC) were assessed.Results5 364 005 patients were included who contributed 44 million person-years of follow-up. 42 125 people had an incident diagnosis of PMR during the period. The overall incidence rate of PMR was 95.9 per 100 000 (95% CI 94.9 to 96.8). The incidence of PMR was highest in women, older age groups and those living in the South of England. Incidence appears stable over time. The prevalence of PMR in 2015 was 0.85 %. The median (IQR) continuous GC treatment duration was 15.8 (7.9–31.2) months. However, around 25% of patients received more than 4 years in total of GC therapy.ConclusionsThe incidence rates of PMR have stabilised. This is the first population-based study to confirm that a significant number of patients with PMR receive prolonged treatment with GC, which can carry significant risks. The early identification of these patients should be a priority in future research.

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Section: Discussioncontrasting

confidence: 74%

Incidence, prevalence and treatment burden of polymyalgia rheumatica in the UK over two decades: a population-based study

Partington

Müller

Helliwell

et al. 2018

Annals of the Rheumatic Diseases

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“…Also in keeping with existing evidence on the propensity of this condition to affect those of Northern European descent, the cohort self-identifies almost entirely as being of white ethnicity, despite having recruited from a large range of geographical areas with differing levels of ethnic diversity. Similarly to a previous population study, there is a broad spread of occupational class across the sample [21]. This suggests that hospital PMR cohorts have similar demographics to this unselected primary care sample, providing some reassurance as to the accuracy of GP diagnosis for participants in this cohort.…”

Section: Discussionsupporting

confidence: 63%

Characterising those with incident polymyalgia rheumatica in primary care: results from the PMR Cohort Study

et al. 2016

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BackgroundThe aim was to characterise the sociodemographic, general health and polymyalgia rheumatica (PMR)-specific features of participants in a large inception cohort of patients with PMR diagnosed in UK primary care.MethodsPatients (n = 739) with a new diagnosis of PMR were referred into the study and mailed a questionnaire detailing their general health and sociodemographic characteristics in addition to the symptoms of and treatment for PMR. Characteristics of responders and non-responders were compared and descriptive statistics were used to characterise the health of the cohort.ResultsA total of 654 individuals responded to the questionnaire (adjusted response 90.1 %). Responders and non-responders were similar in age, gender and deprivation (based on postcode). The mean (standard deviation) age of the recruited cohort was 72.4 (9.3) years; 62.2 % were female. The sample reported high levels of pain and stiffness (8 out of 10 on numerical rating scales) and reported stiffness that lasted throughout the day. High levels of functional impairment, fatigue, insomnia and polypharmacy were also reported. Overall, women reported worse general and PMR-specific health than did men.ConclusionsThis first primary care cohort of patients with incident PMR is similar in demographic terms to cohorts recruited in secondary care. However, the extent of symptoms, particularly reported stiffness, is higher than has been described previously. Given the majority of patients with PMR are exclusively managed in primary care, this cohort provides important information on the course of PMR in the community that will help clinicians managing this painful and disabling condition.

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“…The percentage of specialist referral was as low as 17% in another paper (8). The incidence of PMR does not seem related to socioeconomic status (15).…”

mentioning

confidence: 80%

The role of the general practitioner and the out-of-hospital public rheumatologist in the diagnosis and follow-up of patients with polymyalgia rheumatica

Sobrero

Manzo²,

Stimamiglio³

2018

Reumatismo

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SUMMARYPolymyalgia rheumatica (PMR) is a chronic inflammatory disease characterized by shoulder and pelvic girdle pain. Its onset peaks around the age of 75; the prevalence increases until the age of 90 and it is more frequent in females. Diagnosis is mostly performed on the basis of symptoms. An increase of serum inflammatory markers is indicative, but not essential, while therapy is mainly based on glucocorticoids. Since there is no universal agreement about diagnostic criteria for PMR, its detection is still difficult. There are discordant opinions about the fact that PMR can be recognised and managed by general practitioners (GPs), while patients with atypical features need to be referred to the rheumatologist. In the Italian setting, the absence of recent epidemiological studies is associated with the total lack of a research protocol in primary care, from which relevant information could be derived. The out-of-hospital public rheumatologist is a peculiar figure of the Italian National Health System, who takes care of outpatients. Although differences between the different Italian regional health services exist, this professional figure has proved to be effective in reducing delay and increasing accuracy in PMR diagnosis.

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Association of Polymyalgia Rheumatica With Socioeconomic Status in Primary Care: A Cross‐Sectional Observational Study

Cited by 8 publications

References 14 publications

Incidence, prevalence and treatment burden of polymyalgia rheumatica in the UK over two decades: a population-based study

Incidence, prevalence and treatment burden of polymyalgia rheumatica in the UK over two decades: a population-based study

Characterising those with incident polymyalgia rheumatica in primary care: results from the PMR Cohort Study

The role of the general practitioner and the out-of-hospital public rheumatologist in the diagnosis and follow-up of patients with polymyalgia rheumatica

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