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Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care

Woodhead, C.; Ashworth, M.; Broadbent, B.; Callard, F.; Hotopf, M.; Schofield, P.; Soncul, M.; Stewart, R.J.; Henderson, M.J.

Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care Thumbnail


Authors

C. Woodhead

M. Ashworth

B. Broadbent

F. Callard

M. Hotopf

P. Schofield

M. Soncul

R.J. Stewart

M.J. Henderson



Abstract

Background Suboptimal treatment of cardiovascular diseases (CVD) among patients with severe mental illness (SMI) may contribute to physical health disparities. Aim To identify SMI characteristics associated with meeting CVD treatment and prevention guidelines. Design and 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, UK. Method Cardiovascular disease prevalence, risk factor recording, and Quality and Outcomes Framework (QOF) clinical target achievement were compared among 4056 primary care patients with SMI whose records were linked to secondary healthcare 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 Patients with SMI and with coronary heart disease and heart failure experienced reduced prescribing of beta blockers 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. Conclusion Linking primary and secondary care data allows the identification of patients with SMI most at risk of undertreatment for physical health problems.

Citation

Woodhead, C., Ashworth, M., Broadbent, B., Callard, F., Hotopf, M., Schofield, P., …Henderson, M. (2016). Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care. British Journal of General Practice, 66(647), e374-e381. https://doi.org/10.3399/bjgp16x685189

Journal Article Type Article
Acceptance Date Jan 28, 2016
Online Publication Date Jun 1, 2016
Publication Date Jun 1, 2016
Deposit Date Jun 1, 2016
Publicly Available Date Jun 10, 2016
Journal British Journal of General Practice
Print ISSN 0960-1643
Electronic ISSN 1478-5242
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Volume 66
Issue 647
Pages e374-e381
DOI https://doi.org/10.3399/bjgp16x685189

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Copyright Statement
© British Journal of General Practice 2016 This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.







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