Which comorbidities to include?

[alschaffer]

Current list: diabetes, cardiovascular disease, chronic respiratory disease, liver disease, CKD, osteoarthritis, depression/GAD.

Any other suggestions?

[speed-vm]

To consider adding

1. Inflammatory conditions (Rheumatoid arthritis etc) - this seems to be one type of condition that is missing.
2. Frailty
3. CKD stage 3 and above to pull out those with impaired kidney function.

The ortho comorbidities seem to be under reported given that ~50% are 60 and above. Probably need to look bit further back. This patient would typically be presenting at least once a year for a medication review/bloods so hopefully shouldn't need to go back too far.

[alschaffer]

Thanks @speed-vm. Just some questions about codelists (tagging @chrisjwood16 in case he has insight):

• For RA, there is this codelist (https://www.opencodelists.org/codelist/opensafely/rheumatoid-arthritis/2020-05-12/) and this one that includes SLE/psoriasis (https://www.opencodelists.org/codelist/opensafely/ra-sle-psoriasis/2020-04-14/). Are either appropriate or were you thinking something broader?
• Re: frailty, I suspect this won't be prevalent given the young-ish age and low death rate, but if there is a codelist ready-to-go it is easy enough to add. Is there one in particular you suggest?
• Also, you mentioned looking at mental health broader than depression/GAD. There are two OpenSAFELY codelists for depression/anxiety symptoms (so not just diagnoses) - (depression: https://www.opencodelists.org/codelist/opensafely/symptoms-depression/0e294f34/ and anxiety: https://www.opencodelists.org/codelist/opensafely/symptoms-anxiety/7519dbfe/). Thoughts?

[speed-vm]

Hi @alschaffer , @chrisjwood16

• Suggest to use the pure RA codelist as direct relationship to joints, more so than going for a more broad autoimmune codelist https://www.opencodelists.org/codelist/opensafely/rheumatoid-arthritis/2020-05-12/)

• No frailty codelist ready to go, so perhaps leave that one

• This study protocol has a list of mental health codelists. https://github.com/opensafely/post-covid-mentalhealth/blob/main/protocol/post-covid-events-mentalhealth.pdf
  Think we would be looking to add in that 'combination' codelist for serious mental illness (SMI) + anxiety and + depression

I can't get onto OpenCodelists to check the anxiety and depression ones atm, will have a look when its back online.

[chrisjwood16]

Sorry I've run out of time to look at this fully before Christmas. From a quick look for anxiety and depression the ones Andrea has linked look reasonable so I think worth plugging these in for now. (https://www.opencodelists.org/codelist/opensafely/symptoms-depression/0e294f34/ and https://www.opencodelists.org/codelist/opensafely/symptoms-anxiety/7519dbfe/)

• the depression one actually looks more sensible than the NHS depression refset.

Vicky also mentions including serious mental illness - this is probably a reasonable starting point -https://www.opencodelists.org/codelist/primis-covid19-vacc-uptake-old/sev_mental_cod/v1