Estimating the prevalence and incidence of symptomatic hand OA in the Netherlands using primary care electronic health records.

OBJECTIVE

This study estimated the incidence and prevalence of symptomatic hand osteoarthritis (OA) in the Dutch population using a validated algorithm that integrates free-text data from primary care electronic health records (EHRs).

METHODS

This retrospective cohort study used the Integrated Primary Care Information (IPCI) database, including EHRs from approximately 1.8 million Dutch patients aged ≥30 years between 2013 and 2023. As the International Classification of Primary Care 1 (ICPC-1) lacks a specific code for hand OA, cases were identified using an algorithm combining ICPC-1 codes for hand or wrist complaints and general OA with hand- and OA-related keywords from free-text notes. The algorithm was iteratively refined and validated through manual record review.

RESULTS

Manual review of 100 algorithm-identified records yielded a positive predictive value of 90%. Between 2013 and 2023, 152,900 unique patients with symptomatic hand OA were identified (mean age 68.4 years; 72% female). The age- and sex-standardized prevalence increased by 65% from 5.7% in 2013 to 9.4% in 2023, while incidence rose by 20% from 7.1 to 8.5 per 1,000 person-years. Both measures were consistently higher in women than in men, although the relative increase over time was greater in men.

CONCLUSION

The prevalence and incidence of symptomatic hand OA increased substantially over the past decade in the Netherlands, with the highest absolute burden among women and older adults. These trends underline the rising burden of hand OA and call for greater recognition in healthcare policy, emphasizing the need for targeted management strategies and appropriate allocation of healthcare resources.