KCMHR study exploring veterans’ mental and physical health using one of the world’s largest primary care record databases
A project exploring the mental and physical health needs of veterans using primary care health records is currently underway at KCMHR. This project, which is in collaboration with Imperial College London, is being undertaken by Dr Sharon Stevelink, Professor Nicola Fear, Dr Gemma Archer, Dr Alex Dregan, Mr Shehan Hettiaratchy and Miss Natalia Kika.
The study will explore whether the Clinical Practice Research Datalink (CPRD) can be used to identify veterans and their health needs using electronic general practice (GP) records, and how they differ to those who have not served in the armed forces.
What do we already know?
Previous research has shown that veterans often experience complex and co-occurring mental and physical health issues. Upon transitioning out of the armed forces, the first point of contact for many veterans will be their GP, yet little is known about veterans’ use of primary care services and their health outcomes, particularly for more complex issues where mental and physical health conditions co-occur.
Therefore, the CPRD, one of the world’s largest healthcare databases containing over 60 million anonymised electronic primary care records, could be a valuable new data source for exploring veterans’ health needs and service utilisation.
What will the project focus on?
The study’s project advisory board consists of two GPs who are connected to the Armed Forces community, an independent academic who has previously used CPRD data, a statistician, and a representative from the Royal British Legion.
The study team have already consulted with the advisory board on which health outcomes to explore in the first instance, and will continue to work together on the interpretation of results, to address any challenges, and exchange knowledge and ideas on how to apply the findings to real-life settings.
Work Package 1: Can the CPRD be used to identify veterans’ GP records?
The first work package will explore:
- Whether the CPRD can be used to identify veterans within the UK primary care system, as well as a comparison group of non-veteran patients – we can then explore any differences between veteran and non-veteran health needs;
- Whether we can link the CPRD with other healthcare data sources, such as Hospital Episode Statistics which records patient hospital admissions, and whether this can provide any additional information about veterans’ health;
- What challenges can be expected when using the CPRD to identify veterans – this is particularly important since this resource has not previously been used to explore veterans’ health.
To identify veterans and their health outcomes, the research team will identify relevant codes from a system used by GPs to record information such as a patient’s occupation, medication, or health condition during primary care consultations.
These codes will then be used to extract matching data from electronic records in the CPRD. Initial findings have suggested that we can identify veterans from GP records, and based on this we expect at least 90,000 veteran records to be included in the study.
We will also work with a number of GP practices to ensure that the veterans we have identified match the information they have in their records.
Work Package 2: What can the CPRD tell us about veterans’ physical and mental health?
Since our preliminary findings have shown that the CPRD is a useful resource for identifying veterans’ GP records,, our next steps will include the following aims from the second work package:
- The differences between the sociodemographic (such as gender, age, and socioeconomic status), mental and physical health characteristics of veterans compared to the general population captured in CPRD;
- What can be learned from our findings to improve existing policy and care for veterans and their health needs.
Why is this project important?
The results of this project will help us understand whether electronic GP records can be used to identify veterans’ health needs, and if so, how their needs compare to the general UK population. This is particularly important because while there is some support available for veterans with mental or physical health issues, less is understood about the needs of those with multiple or co-occurring mental and physical health conditions.
Therefore, this project could help clinicians and researchers understand the interplay between physical and mental health conditions, and inform the design of preventative and healthcare strategies for veterans and those leaving the military.
Want to know more?
The project has been running for approx. 6 months and the final project report is due in summer 2024. To find out more about the study, please visit the study webpage.
This project is funded by the Forces in Mind Trust (FiMT).