Characteristics and general practice resource use of people with comorbid cancer and dementia in England: a retrospective cross-sectional study

Collinson, Michelle and Mason, Ellen and Kelly, R and Griffiths, Alys and Ashley, Laura and Henry, Ann and Inman, Hayley and Cowdell, Fiona (2022) Characteristics and general practice resource use of people with comorbid cancer and dementia in England: a retrospective cross-sectional study. BMC Primary Care, 23. p. 281. ISSN 2731-4553

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Cancer and dementia are common in older people and management of the conditions as comorbidities can be challenging, yet little is known about the size or characteristics of this group. We aimed to estimate the prevalence, characteristics and general practice resource usage of people living with both conditions in England.

Anonymised electronic healthcare records from 391 National Health Service general practices across England using the TPP SystmOne general practice system were obtained from ResearchOne. Data included demographic and clinical characteristics, and general practice healthcare useage (appointments, prescriptions, referrals and secondary care contacts) for people aged 50 and over with a cancer and/or dementia diagnosis consistent with the Quality and Outcomes Framework between 2005 and 2016. Multi-level negative binomial regression was used to analyse the number of general practice appointments.

Data from 162,371 people with cancer and/or dementia were analysed; 3,616 (2.2%) people were identified as having comorbid cancer and dementia. Of people with cancer, 3.1% also had dementia, rising to 7.5% (1 in 13 people) in those aged 75 and over. Fewer people with both conditions were female (50.7%) compared to those with dementia alone (65.6%) and those with comorbid cancer and dementia were older than those with cancer alone [mean ages 83 (sd=7), 69 (sd=12) respectively]. Those with both conditions were less likely to have lung cancer than those with cancer alone (7.5% vs. 10.3%) but more likely to have prostate cancer (20.9% vs. 15.8%). Additional comorbidities were more prevalent for those with both conditions than those with cancer or dementia alone (68.4% 54 vs. 50.2% vs. 54.0%). In the year following the first record of either condition, people with cancer and dementia had 9% more general practice appointments (IRR:1.09, 95% 56 CI:1.01-1.17) than those with cancer alone and 37% more appointments than those with dementia alone (IRR: 1.37, 95% CI: 1.28-1.47).

A significant number of people are living with comorbid cancer and dementia in England. This group have additional comorbidity and higher general practice usage than those with cancer/dementia alone. The needs of this group should be considered in future general practice care planning and research.

Item Type: Article
Identification Number:
20 October 2022Accepted
12 November 2022Published Online
Uncontrolled Keywords: cancer, dementia, older adults, primary health care, administrative data, electronic health records, health care resource use, cross-sectional study
Subjects: CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-02 - adult nursing
Divisions: Faculty of Health, Education and Life Sciences > Centre for Social Care, Health and Related Research (C-SHARR)
Depositing User: Fiona Cowdell
Date Deposited: 21 Oct 2022 10:30
Last Modified: 18 Nov 2022 09:50

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