Using the Clinical Practice Research Datalink to understand veterans’ health

Military veterans in the UK have distinct and often complex health needs, yet much of what we know about their health has come from surveys or hospital records, which only capture part of the story. A recent KCMHR project, funded by the Forces in Mind Trust, explored how primary care data can be used to examine veterans’ health at scale using clinically recorded information.

Why this study matters

General practice (GP), or primary care, is the first point of contact for most physical and mental health concerns. As such, primary care data contain detailed information on a wide range of health conditions and risk factors. However, until now, veterans have not been systematically identified within primary care datasets.

The study examined whether the Clinical Practice Research Datalink (CPRD) could be used to identify veterans. CPRD contains anonymised primary care data from about 2,400 NHS GP practices across the UK, covering more than 65 million patients historically and nearly a third of the UK population today.

What the research found

Researchers identified over 138,000 veterans in CPRD across the UK. Findings from those registered with a GP practice in England indicated that compared to non-veterans, veterans had more GP consultations and fewer missing data in their health records, suggesting more consistent health monitoring.

Veterans had a higher prevalence of several physical and mental health conditions, including lower back pain and osteoarthritis, chronic obstructive pulmonary disease (COPD), myocardial infarction, depression and post-traumatic stress disorder (PTSD) – with veterans more than 16 times as likely to have a recorded diagnosis of PTSD. Veterans were also almost three times more likely to live with multiple long-term conditions than non-veterans.

Linking CPRD to hospital records in England improved the completeness of ethnicity data and helped detect additional health conditions, showing veterans had higher rates of hospitalisation for musculoskeletal and cardiovascular issues.

Why these findings matter

One of the study’s key achievements was developing and validating a method to identify veterans in primary care data using clinical coding systems, providing a foundation that can be used by other researchers to explore specific health topics in greater depth. Furthermore, this approach enables direct comparisons between veterans and non-veterans, allowing researchers to understand how military service may shape health outcomes.

By enabling long-term, population-level analysis across physical and mental health, CPRD offers opportunities to monitor health trends over time, identify groups at higher risk, and evaluate policy and service interventions for veterans.

Looking ahead

Building on this work, additional funding has been secured to expand the project across all four UK nations. The new study will examine how health outcomes vary by region and will provide key evidence to inform national policy and targeted support for veterans.

The findings highlight how CPRD can be used to drive improvements in veteran healthcare and research. Future work could explore under-researched groups, such as women, ethnic minority veterans, and different service-era cohorts, and strengthen data linkage to understand the social and environmental factors shaping veterans’ health.

By building on this foundation, researchers, clinicians, and policymakers can work together to ensure that all veterans receive the care, recognition, and support they deserve.

Funding

Forces in Mind Trust

Authors

Pamela Almeida-Meza, Bethany Croak, Alexandru Dregan, Shehan Hettiaratchy, Nicola Fear, and Sharon Stevelink

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