Changes to consultations and diagnosis of osteoarthritis in primary care during the COVID-19 pandemic

Summary

Objective

General practitioners (GP) are often the first medical professionals to treat musculoskeletal complaints. Yet the impact of COVID-19 on primary care utilisation for musculoskeletal complaints is largely unknown. This study quantifies the impact of the pandemic on primary care utilisation for musculoskeletal complaints and specifically osteoarthritis (OA) in the Netherlands.

Design

We extracted data on GP consultations in 2015–2020 from 118,756 patients over 45 years of age and estimated reductions in consultations in 2020 as compared to 5-year average. Outcomes were GP consultations for: any musculoskeletal complaints, knee and hip OA, knee and hip complaints, and newly diagnosed knee and hip OA/complaints.

Results

The relative reductions in consultations ranged from 46.7% (95% confidence intervals (CI): 43.9–49.3%) (all musculoskeletal consultations) to 61.6% (95% CI: 44.7–73.3%) (hip complaints) at the peak of the first wave, and from 9.3% (95% CI: 5.7–12.7%) (all musculoskeletal consultations) to 26.6% (95% CI: 11.5–39.1%) (knee OA) at the peak of the second wave. The reductions for new diagnoses were 87.0% (95% CI: 71.5–94.1%) for knee OA/complaints, and 70.5% (95% CI: 37.7–86.0%) for hip OA/complaints at the peak of the first wave, and not statistically significant at the peak of the second wave.

Conclusion

We observed 47% reduction in GP consultations for musculoskeletal disorders during the first wave and 9% during the second wave. For hip and knee OA/complaints, the reductions were over 50% during the first, and 10% during the second wave. This disruption may lead to accumulation of patients with severe OA symptoms and more requests for arthroplasty surgery.