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Cardiovascular disease treatment among severe mental illness patients: a data linkage study

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)1-16
Number of pages16
JournalBritish Journal of General Practice
Accepted/In press26 Jan 2016

King's Authors

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.

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