Abstract
Background. Sub-optimal treatment of cardiovascular diseases (CVD) among severe mental illness (SMI) patients may contribute to physical health disparities. Aims. To identify SMI characteristics associated with meeting CVD treatment guidelines.Design & setting. Population-based electronic health record database linkage between primary care and the sole provider of secondary mental health care services in South East London, UKMethods. Cardiovascular disease prevalence, risk factor recording and Quality and Outcomes Framework (QOF) clinical target achievement was compared among 4,056 SMI primary care patients whose records were linked to secondary health care records and 270,669 patients without SMI who were not known to secondary care psychiatric services using multivariate logistic regression modelling. Data available from secondary care records were then used to identify SMI characteristics associated with QOF clinical target achievement.Results. SMI patients with coronary heart disease and heart failure experienced reduced prescribing of betablocker and Angiotensin-Converting Enzyme Inhibitor/Angiotensin Receptor Blockers (ACEI/ARB). A diagnosis of schizophrenia, being identified with any indicator of risk or illness severity, and being prescribed with depot injectable antipsychotic medication was associated with the lowest likelihood of prescribing. Conclusions. Linking primary and secondary care data allows the identification of SMI patients most at risk of under treatment for physical health problems.
| Original language | English |
|---|---|
| Pages (from-to) | 1-16 |
| Number of pages | 16 |
| Journal | British Journal of General Practice |
| Publication status | Accepted/In press - 26 Jan 2016 |
Keywords
- SCHIZOPHRENIA
- Cardiovascular Disease
- Quality of care
- Physical health
- Coronary heart disease
- Heart Failure
- HYPERTENSION
- beta blockers
- ACE inhibitor
- Lambeth Datenet
- CRIS
- record linkage
- Severe mental illness
- Electronic health record
- Informatics
