IDENTIFICATION OF ADULT PATIENTS DIAGNOSED WITH RHEUMATIC MUSCULOSKELETAL DISEASE AS CHILDREN OR ADOLESCENTS IN THE AUSTRALIAN OPAL DATASET

Abstract

Aim: To identify patients in adult rheumatology care in Australia who were diagnosed in childhood or adolescence. Method: The OPAL dataset is derived from electronic medical records of 113 rheumatologists around Australia (n=219,812 adult patients). Patients were included if symptoms of their musculoskeletal disease were recorded as starting before the age of 18 years or if their musculoskeletal disease contained the term juvenile, initially using all diseases within International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) Chapter XIII: Diseases of the musculoskeletal system and connective tissue (codes M00-M99). The subgroup of patients diagnosed with an autoimmune disease were also identified. Results: 4,161 patients with at least one musculoskeletal disease diagnosed before the age of 18 years were identified, including 966 young adults (aged 18-24 years) and 3,195 patients aged over 25 years. Median time since first recorded visit was 6.4 years [IQR 3.5-9.4 years], while median duration of disease since symptom onset was 19.8 years [IQR 11.0-32.8 years] for the 3,720 patients with a recorded estimate of symptom onset. Within this population, a subgroup of 2,714 patients with at least one autoimmune condition were identified, including 2,284 patients with arthritis, 157 patients with lupus and 294 patients with other conditions, which included myositis, Sjogren's syndrome, scleroderma, Behcet's disease and other vasculitides. This subgroup included 598 young adults and 2,116 older adults. Median time since first visit recorded in the OPAL dataset was 6.8 years [IQR 3.7-10.1 years], and median duration of disease since symptom onset was 21.8 years [12.3-34.3 years]. Conclusion: A large number of adult patients diagnosed with juvenile rheumatic musculoskeletal disease were identified. These patients have had a substantial disease duration since symptom onset, including several years in adult care after transition. It is vital to understand the burden of disease in this group.L6383267812022-07-01 <br />