Health screening, cardiometabolic disease and adverse health outcomes in individuals with severe mental illness

Robert Pearsall; Richard J Shaw; Gary McLean; Moira Connolly; Kate A Hughes; James G Boyle; John Park; Daniel J Smith; Daniel Mackay

doi:10.1192/bjo.2019.76

Health screening, cardiometabolic disease and adverse health outcomes in individuals with severe mental illness

BJPsych Open. 2019 Nov 8;5(6):e97. doi: 10.1192/bjo.2019.76.

Authors

Robert Pearsall¹, Richard J Shaw², Gary McLean², Moira Connolly³, Kate A Hughes⁴, James G Boyle⁵, John Park⁶, Daniel J Smith⁷, Daniel Mackay⁸

Affiliations

¹ Consultant Psychiatrist and Honorary Clinical Senior Lecturer in Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK.
² Research Associate, Institute of Health and Wellbeing, University of Glasgow, UK.
³ Consultant Psychiatrist, Department of Psychiatry, Gartnavel Royal Hospital, Glasgow, UK.
⁴ Consultant Endocrinologist, Physician and Honorary Senior Lecturer, Department of Medicine, Glasgow Royal Infirmary, UK.
⁵ Consultant Diabetologist and Honorary Clinical Associate Professor, School of Medicine, University of Glasgow, UK.
⁶ RN (Mental Health), Lead Research Nurse, Department of Psychiatry, Stobhill Hospital, UK.
⁷ Professor of Psychiatry, Institute of Health and Wellbeing, University of Glasgow, UK.
⁸ Reader in Public Health, Institute of Health and Wellbeing, University of Glasgow, UK.

Abstract

Background: Poor physical health in severe mental illness (SMI) remains a major issue for clinical practice.

Aims: To use electronic health records of routinely collected clinical data to determine levels of screening for cardiometabolic disease and adverse health outcomes in a large sample (n = 7718) of patients with SMI, predominantly schizophrenia and bipolar disorder.

Method: We linked data from the Glasgow Psychosis Clinical Information System (PsyCIS) to morbidity records, routine blood results and prescribing data.

Results: There was no record of routine blood monitoring during the preceding 2 years for 16.9% of the cohort. However, monitoring was poorer for male patients, younger patients aged 16-44, those with schizophrenia, and for tests of cholesterol, triglyceride and glycosylated haemoglobin. We estimated that 8.0% of participants had diabetes and that lipids levels, and use of lipid-lowering medication, was generally high.

Conclusions: Electronic record linkage identified poor health screening and adverse health outcomes in this vulnerable patient group. This approach can inform the design of future interventions and health policy.

Keywords: Screening; antipsychotic medication; diabetes; physical health; schizophrenia.

Abstract

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