| アブストラクト | BACKGROUND: Evidence on the health needs of UK veterans accessing primary care is limited. Electronic health records (EHRs) offer an opportunity to address this evidence gap if veterans are correctly identified. This study validated the identification of veterans in the Clinical Practice Research Datalink (CPRD) and assessed its feasibility for examining their health compared with non-veterans. METHODS: We conducted a matched cohort study in CPRD, the largest primary care database in the UK, identifying veterans using military-related codes in patients' EHRs. Each veteran was matched to one or two non-veterans on age, gender, practice, and index date. Validation was undertaken through general practitioner confirmation of veteran status. We compared demographics, risk factors and recorded health conditions using descriptive statistics. Poisson regressions assessed the association between veteran status and various physical and mental health conditions. RESULTS: 122,484 veterans and 244,573 matched non-veterans were identified. 95% were captured using definite military terms, and validation showed substantial agreement with GP records. Veterans had higher recorded prevalence across all conditions. The largest differences were observed for PTSD (adjusted prevalence ratio [aPR] 16.43, 95% CI 14.89-18.13), followed by Alzheimer's disease (aPR 2.74, 95% CI 2.56-2.92), alcohol use disorder (aPR 2.23, 95% CI 2.09-2.39), hearing loss (aPR 2.09, 95% CI 2.02-2.15), and osteoarthritis (aPR 1.98, 95% CI 1.93-2.03). Recorded prevalence was also higher among veterans for COPD (aPR 1.83, 95% CI 1.77-1.89), depression (aPR 1.83, 95% CI 1.79-1.87), prostate cancer (aPR 1.83, 95% CI 1.73-1.94), coronary heart disease (aPR 1.78, 95% CI 1.72-1.84), lower back pain (aPR 1.73, 95% CI 1.70-1.77), and myocardial infarction (aPR 1.65, 95% CI 1.56-1.75). Differences for anxiety and breast cancer were modest. CONCLUSIONS: This study establishes a foundation for UK veterans' health research using primary care data. Provided that identification and recording of veteran status improve in NHS records, CPRD offers considerable potential to monitor veteran health trends, identify needs, and evaluate interventions at scale. |
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| 組織名 | Department of Psychological Medicine, Institute of Psychiatry, Psychology &;Neuroscience, King's College London, London, UK. pamela.almeida@kcl.ac.uk.;King's Centre for Military Health Research, King's College London, London, UK.;pamela.almeida@kcl.ac.uk.;Neuroscience, King's College London, London, UK.;Centre for Injury Studies, Imperial College London, London, United Kingdom.;Academic Department of Military Mental Health, King's College London, London, UK. |
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