Proportion of patients with hip osteoarthritis in primary care identified by differing clinical criteria:a cross-sectional study of 4699 patients

Summary: Objective: Differing clinical criteria for hip osteoarthritis (OA) are applied in primary care, but little is known regarding the utility of these criteria. The aim of this study was to evaluate and compare the proportion of patients in a primary care setting with hip OA fulfilling the American College of Rheumatology (ACR), the National Institute for Health and Care Excellence (NICE), and the Danish Health Authority (DHA) criteria. Design: A cross-sectional analysis of baseline data from the Good Life with osteoArthritis in Denmark (GLA:D®) program, a treatment program for patients with symptoms or functional limitations associated with hip OA. The prevalence of hip OA according to the ACR, NICE, and DHA criteria was calculated in all patients and in a subgroup of patients with self-reported radiographic hip OA. Results: 4699 patients were included in the analysis. Mean age (SD) was 66.8 (9.7) years and 71% of the patients were female. 64%, 80%, and 94% fulfilled the ACR, DHA, and NICE criteria, respectively. In those self-reporting radiographic hip OA, the corresponding numbers were 66%, 81%, and 94%. A limited number of patients (4%) did not fulfill any of the criteria. Conclusions: The NICE criteria identified the most patients that were treated because of their symptoms or functional limitations. The DHA and especially the ACR criteria did not identify a significant proportion of these patients. The results suggest the NICE criteria are appropriate to identify individuals treated for hip OA in primary care

Prevalence and consequences of spinal pain among people with type 1 and type 2 diabetes mellitus in Denmark

Purpose: To describe 1-week and 1-year prevalence of spinal pain and its consequences in relation to leisure activity, work-life, and care-seeking in people with type 1 and 2 diabetes mellitus (DM). Methods: A cross-sectional survey including adults diagnosed with DM from two Danish secondary care centres. Using the Standardised Nordic Questionnaire, spinal pain prevalence (cervical, thoracic, lumbar) and its consequences were evaluated (proportions, 95% confidence intervals) and compared to the general population. Results: Among 3767 people, 1-week and 1-year spinal pain prevalence were 11.6–32.4 and 18.5–49.6%, respectively, highest for lumbar pain (24.6–49.6%). The prevalence was similar between DM types for cervical and thoracic pain, but higher in type 2 for lumbar spine. Women had higher pain prevalence across spinal regions and DM types, while cervical and thoracic pain estimates were higher for age &lt; 60 vs. ≥ 60. Within the past year, &gt; 50% reported pain &gt; 30 days, high proportions had reduced their activities (leisure time, 43.7–63.9%; work, 20.7–33.3%), 13.3–28.1% reported sick-leave &gt; 30 days, and 44.3–48.5% had sought care due to spinal pain. Conclusion: Spinal pain is common in people with type 1 and 2 DM, resulting in considerable consequences for work/leisure activities, sick-leave, and healthcare utilisation as compared to the general population.</p

Optimal outcomes from cardiac rehabilitation are associated with longer-term follow-up and risk factor status at 12 months : An observational registry-based study

AIM: The purpose of Cardiac Rehabilitation (CR) is to promote and reduce risk factors in the short and long term, however, the latter has, to date, been poorly evaluated. We explored characteristics associated with provision and outcomes of a long-term assessment in CR. METHOD: Data from the UK National Audit of CR between April 2015 and March 2020 was used. Programmes were selected if they had an established mechanism and routine methodology to collect the 12-month assessments. Risk factors pre and post phase II CR and at the 12-month assessment were explored; BMI ≤30, ≥150 min of physical activity per week, hospital anxiety and depression scale (HADS) scores <8. The data came from 32 programmes, 24,644 patients with coronary heart disease. Patients being in at least one optimal risk factor stage throughout phase II CR (OR = 1.43 95% CI 1.28 to 1.59) or successfully reaching an optimal stage during phase II CR (OR = 1.61 95% CI 1.44 to 1.80) had an increased likelihood of being assessed at 12 months compared to those who did not. Patients being in the optimal stage upon completion of phase II CR had an increased likelihood of still being in the optimal stage at 12 months. Most prominent was BMI; (OR = 14.6 (95% CI 11.1 to 19.2) for patients reaching an optimal stage throughout phase II CR. CONCLUSION: Being in an optimal stage upon routine CR completion could be an overlooked predictor in the provision of a long-term CR service and prediction of longer-term risk factor status