Prevalence and management of osteoarthritis in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network.

BACKGROUND Osteoarthritis is a common chronic condition that affects many older Canadians and is a considerable cause of disability. Our objective was to describe the epidemiology of osteoarthritis in patients aged 30 years and older using electronic medical records (EMRs) in a Canadian primary care population. METHODS In this retrospective cohort study, we analyzed the EMRs of 207 610 patients over 30 years of age (extracted on December 31, 2012) who had at least one clinic visit during the preceding 2 years. We calculated the age-sex standardized prevalence of diagnosed osteoarthritis and its association with comorbidities and covariates available in the Canadian Primary Care Sentinel Surveillance Network database. RESULTS The estimated prevalence of diagnosed osteoarthritis was 14.2% (15.6% among women, 12.4% among men). The diagnosis of osteoarthritis was associated with several comorbidities: hypertension (prevalence ratio [PR] 1.17, 95% confidence interval [CI] 1.15-1.18), depression (PR 1.26, 95% CI 1.22-1.3), chronic obstructive pulmonary disease (COPD) (PR 1.16, 95% CI 1.11-1.21) and epilepsy (PR 1.27, 95% CI 1.13-1.43). In addition, 56.6% of patients had received a prescription for a range of nonsteroidal anti-inflammatory drugs, 45% of which were topical. Opioid medications were prescribed to 33% of patients for pain management. CONCLUSION Osteoarthritis is a common disease in middle-aged and older Canadians. It is more common in women than in men and is associated with comorbid conditions. Most patients with osteoarthritis received pharmacotherapy for inflammation and pain management. As the Canadian population ages, osteoarthritis will become an increasing burden for individuals and the health care system.

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