Thank you to everyone who has expressed interest in the clinical intelligence article on polymyalgia rheumatica (PMR). PMR is largely managed in the community. It has been shown that management varies widely1 and diagnostic criteria are rarely used.2 We hope that by summarising the recent British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) guidance3 we can help to improve outcomes for patients with PMR being managed in general practice.
We apologise for any confusion caused with the consultation estimates presented in the paper. Evidence from electronic consultation databases suggests that the ‘average’ general practice will have 20 patients per year consulting with PMR.4 This will be a mix of newly diagnosed patients, in addition to prevalent cases. The Musculoskeletal Matters bulletin assumes an average practice size of 10 000 patients with four full-time doctors, which we acknowledge may not reflect the true ‘average’ sized practice. In this scenario GPs will see around five patients with PMR per year. The true consultation frequency may also vary for other reasons. In the UK, the age adjusted incidence rate is estimated to be around 8.4 per 10 000 patient years.5 There are marked geographical differences found in the incidence of PMR. Incidence also varies greatly with age and sex and as such exact numbers of new patients seen will vary depending on the demographic make-up of the practice (for example, incidence rises from 0.65 per 10 000 patient years for females aged 40–49 years, to 26.9 per 10 000 patient years for females aged 70–79 years).
Optimising the diagnosis and management of PMR is hindered by the lack of primary care-based evidence. If BJGP readers are interested in participating in PMR research please get in touch using the contact details given below.
- © British Journal of General Practice 2012
