Background: Posttraumatic stress disorder (PTSD) has significant morbidity and economic costs. This study describes the prevalence and characteristics of patients with PTSD using primary care electronic medical record (EMR) data.
Methods: This retrospective cross-sectional study used EMR data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). This study included 1,574 primary care providers located in 7 Canadian provinces. There were 689,301 patients that visited a CPCSSN provider between 1 January 2017 and 31 December 2019. We describe associations between PTSD and patient characteristics using descriptive statistics, chi-square, and multiple logistic regression models.
Results: Among the 689,301 patients included, 8,817 (1.3%, 95% CI 1.2-1.3) had a diagnosis of PTSD. On multiple logistic regression analysis, patients with depression (OR 4.4, 95% CI 4.2-4.7, P < 0.001), alcohol abuse/dependence (OR 1.7, 95% CI 1.6-1.9, P < 0.001), and/or drug abuse/dependence (OR 2.6, 95% CI 2.5-2.8, P < 0.001) had significantly higher odds of PTSD compared with patients without those conditions. Patients residing in community areas considered the most material deprived (OR 2.1, 95% CI 1.5-2.1, P < 0.001) or the most socially deprived (OR 2.8, 95% CI 2.7-5.3, P < 0.001) had higher odds of being diagnosed with PTSD compared with patients in the least deprived areas.
Conclusions: The prevalence of PTSD in Canadian primary care is 1.3% (95% CI 1.25-1.31). Using EMR records we confirmed the co-occurrence of PTSD with other mental health conditions within primary care settings suggesting benefit for improved screening and evidence-based resources to manage PTSD.
Keywords: access; alcohol drinking; and evaluation; electronic health records; healthcare quality; posttraumatic; primary healthcare; social determinants of health; stress disorders.
Posttraumatic stress disorder (PTSD) is a mental health disorder with symptoms presenting after having experienced or witnessed a traumatic event. PTSD symptoms continue for more than 1 month after the event and negatively impact the health and social wellbeing of an individual. Primary care, including family doctors, nurse practitioners, and community paediatricians, are often the first point of healthcare for an individual. This study found that PTSD is diagnosed and managed in primary care. Patients with PTSD had comorbidities, substance use, and visited their primary care provider more frequently. Additionally, patients with PTSD often live in a community area that is experiencing high material and social deprivation. The presence of PTSD in primary care suggests the need for new and additional evidence-based resources to assist in managing this complex condition.
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