Sequence Analysis to Phenotype Health Care Patterns in Adults With Musculoskeletal Conditions Using Primary Care...

Area of Science:

• Primary Care Research
• Health Services Research
• Musculoskeletal Health

Background:

• Musculoskeletal (MSK) conditions are a leading cause of disability.
• Understanding patient healthcare journeys in primary care is crucial for effective management.
• Electronic health records (EHRs) offer valuable data for analyzing healthcare patterns.

Purpose of the Study:

• To apply sequence analysis (SA) to phenotype primary care utilization patterns in adult MSK patients.
• To investigate the association between identified healthcare patterns and self-reported patient outcomes.

Main Methods:

• Utilized data from the Multilevel Integrated Data for musculoskeletal health intelligence and Actions program.
• Applied SA to categorize 1,875 adult MSK patients based on primary care consultations, prescriptions, imaging, physiotherapy, and referrals over five years.
• Analyzed associations between sociodemographic factors, self-reported outcomes, and identified healthcare clusters.

Main Results:

• Identified five distinct healthcare pattern clusters: 'increasing consultation and analgesia', 'low consultation and health care use', 'high consultation and health care use', 'low consultation but high analgesia', and 'low consultation but moderate health care use'.
• The 'high consultation and health care use' cluster comprised older, predominantly female patients with obesity, more comorbidities, and from deprived areas.
• Patients in the 'high consultation and health care use' cluster reported significantly worse self-reported outcomes compared to the 'low consultation and health care use' group.

Conclusions:

• Sequence analysis successfully identified five distinct healthcare utilization patterns among primary care patients with MSK conditions.
• Significant variations exist in sociodemographic profiles and self-reported outcomes across these identified healthcare pattern clusters.
• These findings highlight the heterogeneity of MSK patient journeys and their impact on outcomes, suggesting potential for tailored interventions.