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Can patients with osteoporosis, who should benefit from implementation of the national service framework for older people, be identified from general practice computer records? A pilot study that illustrates the variability of computerized medical records and problems with searching them.

de Lusignan, S, Chan, T, Wells, S, Cooper, A, Harvey, M, Brew, S and Wright, M (2003) Can patients with osteoporosis, who should benefit from implementation of the national service framework for older people, be identified from general practice computer records? A pilot study that illustrates the variability of computerized medical records and problems with searching them. Public Health, 117 (6). pp. 438-445.

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Abstract

Although UK general practice is highly computerized, comprehensive use of these computers is often limited to registration data and the issue of repeat prescriptions. The recording of diagnostic data is patchy. This study examines whether patients with, or at risk of, osteoporosis can be readily identified from general practice computer records. It reports the findings of a pilot study designed to show the variability of recording the diagnosis of osteoporosis and osteopenia, as well as how useful surrogate markers might be to identify these patients. The study also illustrates the difficulties that even skilled practitioners in a primary care research network experience in extracting clinical data from practice information systems. Computer searches were carried out across six practices in a general practice research network in the south-east of England. Two of these practices had previously undertaken research projects in osteoporosis and were consequently expected to have excellent data quality in osteoporosis. These two practices had a combined list size of 27,500 and the remaining practices had a combined practice population of 43,000 patients. The data were found to be variable with over 10-fold differences between practices in the recorded prevalence of osteoporosis diagnosis as well as its surrogate markers-such as fragility fractures, long-term steroid prescription, etc. There was no difference in data quality between the two practices that had conducted osteoporosis research and the rest of the group, other than in the areas of diagnostic recording and prescribing for osteoporosis and recording of fractures. Issues were raised by the practices that struggled to identify patients at risk of osteoporosis about the limitations of Read classification in this disease area. Practices need further assistance if the patients at risk are to be identified. Without urgent action, it will be difficult for practices to identify the patients who are likely to benefit from Standard 6-'Falls' of the National Service Framework for Older People. These findings also have broader implications as UK general practice moves towards the implementation of a quality-based contract.

Item Type: Article
Divisions : Faculty of Arts and Social Sciences > Surrey Business School
Authors :
AuthorsEmailORCID
de Lusignan, SUNSPECIFIEDUNSPECIFIED
Chan, TUNSPECIFIEDUNSPECIFIED
Wells, SUNSPECIFIEDUNSPECIFIED
Cooper, AUNSPECIFIEDUNSPECIFIED
Harvey, MUNSPECIFIEDUNSPECIFIED
Brew, SUNSPECIFIEDUNSPECIFIED
Wright, MUNSPECIFIEDUNSPECIFIED
Date : November 2003
Identification Number : https://doi.org/10.1016/S0033-3506(03)00129-X
Uncontrolled Keywords : Aged, England, Family Practice, Female, Health Services Accessibility, Health Services Research, Humans, Information Storage and Retrieval, Male, Medical Records Systems, Computerized, Middle Aged, Osteoporosis, Pilot Projects, Population Surveillance, Prevalence, Public Health Informatics, State Medicine
Additional Information : NOTICE: this is the author’s version of a work that was accepted for publication in Public Health. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Public Health, 117(3), December 2011,DOI 10.1016/S0033-3506(03)00129-X.
Depositing User : Symplectic Elements
Date Deposited : 23 Feb 2012 16:52
Last Modified : 28 Mar 2017 15:03
URI: http://epubs.surrey.ac.uk/id/eprint/186014

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