Risk factors and secondary care utilisation in a primary care population with nontuberculous mycobacterial disease in the UK
File(s)
Published version
Author(s)
Axson, Eleanor
Bual, Navdeep
Bloom, Chloe
Quint, Jennifer
Type
Journal Article
Abstract
Prior research has identified risk factors associated with developing non-tuberculous mycobacterial disease (NTMD); we identified risk factors and secondary care utilisation of NTMD patients in the UK. This was a matched case-control study using electronic healthcare records from Clinical Practice Research Datalink from 2006 to 2016. NTMD was defined using prescription data and Read codes, based on international guidelines. Risk factors for NTMD were investigated using conditional logistic regression within a representative general population. All-cause secondary care utilisation (combined inpatient, outpatient, emergency visits) was investigated for participants with linked Hospital Episode Statistics (HES), using incidence rate ratio (IRR) from 2007 to 2015. We identified 1225 individuals with NTMD. A subset of individuals (426 patients) were eligible for linkage with HES. In the adjusted model, risk factors most strongly associated with an increased likelihood of NTMD included previous tuberculosis (OR 69.0; 47.7–99.8); bronchiectasis (OR 23.3; 12.4–43.9); lung cancer (OR 14.9; 3.98–55.7); oral corticosteroids (OCS; OR 7.28; 4.94–10.7); immunosuppressive (excluding corticosteroids) medication (OR 3.05; 1.15–8.10); being underweight (odds ratio (OR) 2.92; 95% CI 1.95, 4.36); and rheumatoid arthritis (OR 2.12; 1.05–4.27). NTMD patients had significantly higher rates of all-cause secondary care utilisation than non-NTMD patients (IRR 5.80; 5.14–6.46). Using a representative adult population, we identified prior TB, bronchiectasis, lung cancer, immunosuppressive medication, and OCS as the risk factors associated with the highest odds of developing NTMD in the UK. Patients with NTMD experienced nearly six times more all-cause secondary care events following their NTMD diagnosis than patients without NTMD.
Date Issued
2019-01-01
Date Acceptance
2018-08-16
Citation
Thorax
ISSN
1468-3296
Publisher
BMJ Publishing Group
Start Page
117
End Page
124
Journal / Book Title
Thorax
Volume
38
Issue
1
Copyright Statement
© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor
Insmed Limited
Grant Number
n/a
Source
BTS Winter Meeting
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Microbiology
Epidemiology
Risk factors
NTM
COPD
Bronchiectasis
INFECTIONS
BRONCHIECTASIS
06 Biological Sciences
11 Medical And Health Sciences
Publication Status
Published
Start Date
2018-12-05
Coverage Spatial
London, England
Date Publish Online
2018-10-27