Profile and Trends in Comorbidity for Patients Undergoing Hip and Knee Arthroplasty Using the Rx-Risk Measure with Pharmaceutical Dispensing Records

• DOI: 10.23889/ijpds.v5i5.1608
• Publication Date: 2020-12-07T16:23:30Z
• Authors: Mhairi Kerr; Stephen E Graves; Nicole Pratt; Maria Inacio; Katherine Duszynski; Aarti Gulyani; Richard De Steiger; Ian Harris; Ilana Ackerman; Louisa Jorm; Michelle Lorimer
• Keywords: Demography. Population. Vital events; 610; HB848-3697; 3. Good health

IntroductionPatient comobidity at time of primary joint replacement (JR) impacts on outcomes including revision and mortality. Understanding changes in comorbidity profiles is important when assessing change over time. Most arthroplasty registries have limited information due to their minimum dataset. One approach obtaining additional data linking registry with national administrative data. Objectives ApproachObjectives were quantify pre-operative profile patients undergoing total hip (THR) knee (TKR) for osteoarthritis. Also, examine temporal trends individual comorbidities THR TKR patients. National pharmaceutical dispensing linked Medication histories 12-months preceding JR (2003-2017) 237,333 394,965 patients, mapped 47 classes using the Rx-Risk-V measure - a pharmacy-based comorbidity. Comorbidity scores calculated by summing categories Trends scores/categories described, presented PBS beneficiary category (concessional/general), stratified age (<65/≥65 years). ResultsMedian (interquartile range) higher concessional ≥65y, THR:5(3-6), TKR:5(3-7); <65y,TKR:5(3-6) but not THR:4(2-6). Comparative general (both ages) THR:4(2-6) TKR:3(2-5). median consistent across study period, THR:4- 5(concessional)/2-3(general) TKR:4-5(concessional)/4(general). Commonly identified younger pain, measured opioid use (62.4%), inflammation/pain, non-steroidal anti-inflammatories (62.2%), GORD (36.2%) hypertension (36.1%). Individual remained generally stable However, increased patient proportions seen concessionals <65y pain (59.1%-71.1%), depression (24.5-42.5%), whilst inflammation/pain (82.1-56.1%) antiplatelet (≥65y:23.5-9.2%) declined. Conclusion / Implicationsn or no appreciable score occurred This suggests that improving are unlikely solely variation profiles.