Characterizing primary care patients with posttraumatic stress disorder using electronic medical records: a retrospective cross-sectional study

Abstract

Abstract 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.