Epidemiology of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis among 1.5 million patients in Australian general practice: NPS MedicineWise MedicineInsight dataset

González‐Chica, David Alejandro; Vanlint, Simon; Hoon, Elizabeth; Stocks, Nigel

doi:10.1186/s12891-018-1941-x

Cited by 57 publications

(59 citation statements)

References 31 publications

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“…The NPS MedicineWise's MedicineInsight data has been described elsewhere . This dataset was collected from 329 participating practices representing 1 483 416 active patients from 1st June 2013 until 30th June 2016.…”

Section: Methodsmentioning

confidence: 99%

“…The National Prescribing Service (NPS) MedicineWise MedicineInsight dataset is the largest and most representative general practice/primary care clinical dataset yet developed in Australia; it currently has over 650 recruited general practices, providing a database of over 3.6 million records of Australian patients. Since 2013, general practices and GP across Australia have been able to contribute their data.…”

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confidence: 99%

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Epidemiology of chronic kidney disease in Australian general practice: National Prescribing Service MedicineWise MedicineInsight dataset

et al. 2018

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Aim To describe sociodemographic characteristics and comorbidities of a large cohort of Australian general practice‐based patients identified as having chronic kidney disease (CKD), using data from National Prescribing Service (NPS) MedicineWise's MedicineInsight dataset, and compare this dataset to the 2011–2012 Australian Health Survey's (AHS) CKD prevalence estimates. Methods This was a cohort study using deidentified, longitudinal, electronic health record data collected from 329 practices and 1 483 416 patients distributed across Australia, from 1 June 2013 until 1 June 2016. Two methods were used to calculate the CKD prevalence. One used the same method as used by the 2011–2012 AHS, based on one estimate of the estimated glomerular filtration rate (eGFR) or albumin/creatinine ratios (ACR). The other defined CKD more rigorously using eGFR or ACR results at least 90 days apart. Results In 2016, of 1 310 602 active patients, 710 674 (54.2%) did not have an eGFR or ACR test, while 524 961 (40.1%) had an eGFR or ACR test but did not meet AHS criteria for CKD. Age–sex adjusted rates of CKD (compared to AHS) were CKD 1–0.45% (3.9%), CKD 2–0.62% (2.5%), CKD 3a: 3.1% (2.7%), CKD 3b: 1.14% (0.6%), CKD 4–5: 0.41% (0.3%). The CKD cohort defined more rigorously using eGFR and ACR measures >90 days apart, had comorbidities of atrial fibrillation (30.5%), cardiovascular disease (25.0%), diabetes mellitus (17.1%) and hypertension (14.8%). Conclusion The MedicineInsight dataset contains valuable and timely information about Australian patients with CKD, and provides prevalence estimates similar to those from AHS data.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Epidemiology of chronic kidney disease in Australian general practice: National Prescribing Service MedicineWise MedicineInsight dataset

et al. 2018

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“…A total of 2,974,031 included patients had at least three clinical encounters in the previous two years. Details about this dataset can be found elsewhere [2,[14][15][16]. We used MedicineInsight data collected from 329 general practices between 1 January 2013 and 1 June 2016.…”

Section: Methodsmentioning

confidence: 99%

Medication Prescribing Quality in Australian Primary Care Patients with Chronic Kidney Disease

Bezabhe

Kitsos

Saunder

et al. 2020

JCM

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Background: Australian patients with chronic kidney disease (CKD) are routinely managed in general practices with multiple medications. However, no nationally representative study has evaluated the quality of prescribing in these patients. The objective of this study was to examine the quality of prescribing in patients with CKD using nationally representative primary care data obtained from the NPS MedicineWise’s dataset, MedicineInsight. Methods: A cross-sectional analysis of general practice data for patients aged 18 years or older with CKD was performed from 1 February 2016 to 1 June 2016. The study examined the proportion of patients with CKD who met a set of 16 published indicators in two categories: (1) potentially appropriate prescribing of antihypertensives, renin-angiotensin system (RAS) inhibitors, phosphate binders, and statins; and (2) potentially inappropriate prescribing of nephrotoxic medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), at least two RAS inhibitors, triple therapy (an NSAID, a RAS inhibitor and a diuretic), high-dose digoxin, and metformin. The proportion of patients meeting each quality indicator was stratified using clinical and demographic characteristics. Results: A total of 44,259 patients (24,165 (54.6%) female; 25,562 (57.8%) estimated glomerular filtration (eGFR) 45–59 mL/1.73 m2) with CKD stages 3–5 were included. Nearly one-third of patients had diabetes and were more likely to have their blood pressure and albumin-to-creatinine ratio monitored than those without diabetes. Potentially appropriate prescribing of antihypertensives was achieved in 79.9% of hypertensive patients with CKD stages 4–5. The prescribing indicators for RAS inhibitors in patients with microalbuminuria and diabetes and in patients with macroalbuminuria were achieved in 69.9% and 62.3% of patients, respectively. Only 40.8% of patients with CKD and aged between 50 and 65 years were prescribed statin therapy. The prescribing of a RAS inhibitor plus a diuretic was less commonly achieved, with the indicator met in 20.6% for patients with microalbuminuria and diabetes and 20.4% for patients with macroalbuminuria. Potentially inappropriate prescribing of NSAIDs, metformin, and at least two RAS inhibitors were apparent in 14.3%, 14.1%, and 7.6%, respectively. Potentially inappropriate prescribing tended to be more likely in patients aged ≥65 years, living in regional or remote areas, or with socio-economic indexes for areas (SEIFA) score ≤ 3. Conclusions: We identified areas for possible improvement in the prescribing of RAS inhibitors and statins, as well as deprescribing of NSAIDs and metformin in Australian general practice patients with CKD.

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“…Gout is the most common inflammatory arthritis in men . The prevalence of gout in Australia is 1.6% of patients attending general practices, and this is increasing, reflecting a world‐wide phenomenon in both developed and developing nations . In the 2007–08 National Health Survey, 4.7% of working age Australians self‐reported gout .…”

Section: About Goutmentioning

confidence: 99%

“…10 The prevalence of gout in Australia is 1.6% of patients attending general practices, and this is increasing, reflecting a world-wide phenomenon in both developed and developing nations. [11][12][13] In the 2007-08 National Health Survey, 4.7% of working age Australians self-reported gout. 14 In a 2015 South Australian population survey, gout prevalence was reported to be 6.8%.…”

Section: About Goutmentioning

confidence: 99%

Management of gout in older people

Day

Lau

Stocker

et al. 2019

Pharmacy Practice and Res

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Gout is an inflammatory musculoskeletal disorder with a prevalence of 1.6–6.8% in Australia. Gout is characterised by acute attacks of severe joint pain secondary to raised serum concentrations of uric acid and joint deposits of monosodium urate crystals. Recurrent attacks can affect quality of life and lead to irreversible joint damage. The prevalence of gout is increased in older people, and age‐related renal impairment, altered drug distribution and increased prevalence of comorbidities have significant consequences for safe and effective gout pharmacotherapy. For treatment of acute attacks in older people, dose reduction of colchicine may be needed due to renal impairment, and potential drug interactions require consideration. Use of non‐steroidal anti‐inflammatory drugs is limited by peptic ulceration, ischaemic heart disease, hypertension and renal impairment. Short courses of oral glucocorticoids may be preferable. For long‐term urate‐lowering therapy, allopurinol, probenecid and febuxostat are available in Australia. Lower starting doses of allopurinol are recommended in patients with renal impairment, but dose escalation to achieve target urate should follow. Concerns regarding increased cardiovascular risk with febuxostat are relevant to older patients. Despite the availability of effective therapy, gout remains undertreated, with maintenance of urate‐lowering therapy a major challenge. Education of patients and health professionals is essential to improve adherence to therapy.

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Epidemiology of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis among 1.5 million patients in Australian general practice: NPS MedicineWise MedicineInsight dataset

Cited by 57 publications

References 31 publications

Epidemiology of chronic kidney disease in Australian general practice: National Prescribing Service MedicineWise MedicineInsight dataset

Epidemiology of chronic kidney disease in Australian general practice: National Prescribing Service MedicineWise MedicineInsight dataset

Medication Prescribing Quality in Australian Primary Care Patients with Chronic Kidney Disease

Management of gout in older people

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