Characterising intra-articular corticosteroid injections use in UK primary care: a retrospective cohort study between 2005 and 2020

Abstract Objectives To characterise the use of intra-articular corticosteroid injections (IACIs) in a large patient cohort with osteoarthritis (OA) in UK primary care from 2005 to 2020. We sought to evaluate IACI practices, identify patterns of administration across different joints, assess regional variation, and examine potential demographic factors influencing IACI utilisation for managing OA. Methods This retrospective cohort study used data from the UK Clinical Practice Research Datalink GOLD, a database of primary care health records. Data from other healthcare settings were not included. Patients aged 20 years and older with a first diagnosis of OA between 2005-2019 were included. OA and IACIs were identified through Read and Gemscript codes respectively. Results Of 220,125 patients with OA, 11% received at least one IACI. Anatomical location was only specified in 56% of IACI records. The highest proportion of injections occurred in patients with multiple joints diagnosed with OA (19.0%), followed by shoulder (14.9%) and knee (12.5%). The median time from OA diagnosis to first injection was 0.9 years, shortest for shoulder (0.3 years) and longest for elbow (2.1 years). We observed substantial regional variation, with incidence rates ranging from 1.2 injections per 100 patient-years in the South East Coast to 3.8 in Yorkshire and the Humber. Conclusion This study observed notable variation in the median time from OA diagnosis to injection, across different joints, with substantial heterogeneity in the incidence of IACIs across UK regions.