Dr Pamela Almeida-Meza - Unlocking a new resource for veteran health research: The Clinical Practice Research Datalink
Dr Pamela Almedia-Meza outlines how, now her team has developed a way to identify veterans, we can use routinely collected GP data to improve healthcare services for them
This month’s Military Mind and Body theme invites us to consider the full spectrum of physical and psychological experiences that shape life after service. For the UK’s 1.8 million veterans, the transition from military to civilian life can bring a range of unique challenges, from rebuilding identity and relationships, to navigating chronic physical health conditions and mental health difficulties. Yet despite long-standing commitments through the Armed Forces Covenant, our understanding of veterans’ health in the UK remains incomplete.
A key challenge is that we lack large-scale, clinically verified, population-level primary care data on veterans. Without a dedicated administrative system for veteran health, the UK has depended on cohort and survey studies which have offered deep insights into specific groups but cannot represent all veterans in the UK. Therefore, primary care data offers an opportunity to examine veterans’ health at scale using clinically recorded information from across the country.
Primary care data
Primary care is where most health needs first emerge. General practitioners manage around 90% of all physical and mental health concerns, making their records a rich reflection of the population’s health. Veterans are encouraged to register with an NHS GP when they leave the Armed Forces, and their military history should be recorded in their electronic health records (although this does not always happen).
The Clinical Practice Research Datalink (CPRD) contains anonymised electronic health records from about 2,000 NHS GP practices across the UK, covering more than 70 million patients historically and nearly a third of today’s UK today. Despite its potential, CPRD had not been used to study veterans.
Identifying veterans in CPRD
A feasibility study funded by Forces in Mind Trust and led by researchers at the King’s Centre for Military Health Research, King’s College London identified over 130,000 veterans within CPRD. This represents the first-time veterans have been systematically identified in primary care data across the UK.
Early findings from England confirm what many clinicians and researchers have long suspected, compared to non-veterans, veterans present with higher rates of both mental and physical health problems, including PTSD, depression, chronic obstructive pulmonary disease, lower back pain, osteoarthritis, and myocardial infarction. These patterns raise questions about the interaction of mental and physical health conditions in veterans, highlighting the value of future studies examining these together.
CPRD includes many groups traditionally hard to reach through surveys, including women and ethnic minority veterans, allowing meaningful analysis of how health needs might differ within and across the veteran population.
CPRD represents a transformative addition to the UK’s veteran health evidence base. By unlocking primary care data, we can start to get a clearer picture of the mental and physical health needs across all veterans, not just the groups who participate in surveys or appear in hospital records. This work sets a new benchmark for future research and offers real potential to improve support and reduce inequalities, upholding the Armed Forces Covenant.
