Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK
Objectives Little is known about the prevalence of comorbidity rates in people with severe mental illness (SMI) in UK primary care. We calculated the prevalence of SMI by UK country, English region and deprivation quintile, antipsychotic and antidepressant medication prescription rates for people wi...
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BMJ Publishing Group
2015-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/5/12/e009010.full |
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| author | Tim Doran Darren M Ashcroft Evangelos Kontopantelis David Reeves Siobhan Reilly Claire Planner Ivan Olier Linda Gask |
| author_facet | Tim Doran Darren M Ashcroft Evangelos Kontopantelis David Reeves Siobhan Reilly Claire Planner Ivan Olier Linda Gask |
| author_sort | Tim Doran |
| collection | DOAJ |
| description | Objectives Little is known about the prevalence of comorbidity rates in people with severe mental illness (SMI) in UK primary care. We calculated the prevalence of SMI by UK country, English region and deprivation quintile, antipsychotic and antidepressant medication prescription rates for people with SMI, and prevalence rates of common comorbidities in people with SMI compared with people without SMI.Design Retrospective cohort study from 2000 to 2012.Setting 627 general practices contributing to the Clinical Practice Research Datalink, a UK primary care database.Participants Each identified case (346 551) was matched for age, sex and general practice with 5 randomly selected control cases (1 732 755) with no diagnosis of SMI in each yearly time point.Outcome measures Prevalence rates were calculated for 16 conditions.Results SMI rates were highest in Scotland and in more deprived areas. Rates increased in England, Wales and Northern Ireland over time, with the largest increase in Northern Ireland (0.48% in 2000/2001 to 0.69% in 2011/2012). Annual prevalence rates of all conditions were higher in people with SMI compared with those without SMI. The discrepancy between the prevalence of those with and without SMI increased over time for most conditions. A greater increase in the mean number of additional conditions was observed in the SMI population over the study period (0.6 in 2000/2001 to 1.0 in 2011/2012) compared with those without SMI (0.5 in 2000/2001 to 0.6 in 2011/2012). For both groups, most conditions were more prevalent in more deprived areas, whereas for the SMI group conditions such as hypothyroidism, chronic kidney disease and cancer were more prevalent in more affluent areas.Conclusions Our findings highlight the health inequalities faced by people with SMI. The provision of appropriate timely health prevention, promotion and monitoring activities to reduce these health inequalities are needed, especially in deprived areas. |
| format | Article |
| id | doaj-art-59edc4df6e694798a562303f0f6f7f59 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2015-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-59edc4df6e694798a562303f0f6f7f592025-02-11T16:40:14ZengBMJ Publishing GroupBMJ Open2044-60552015-12-0151210.1136/bmjopen-2015-009010Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UKTim Doran0Darren M Ashcroft1Evangelos Kontopantelis2David Reeves3Siobhan Reilly4Claire Planner5Ivan Olier6Linda Gask74Department of Health Sciences, University of York, York, UKCentre for Pharmacoepidemiology and Drug Safety, NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, Division of Pharmacy and Optometry, University of Manchester, Manchester, UKNIHR School for Primary Care Research, Centre for Primary Care and Health Services Research, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UKCentre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), The University of Manchester, Manchester, UKDivision of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UKThe University of Manchester, Manchester, United Kingdom2Manchester Institute of Biotechnology, University of Manchester, Manchester, UKemerita professor of primary care psychiatryObjectives Little is known about the prevalence of comorbidity rates in people with severe mental illness (SMI) in UK primary care. We calculated the prevalence of SMI by UK country, English region and deprivation quintile, antipsychotic and antidepressant medication prescription rates for people with SMI, and prevalence rates of common comorbidities in people with SMI compared with people without SMI.Design Retrospective cohort study from 2000 to 2012.Setting 627 general practices contributing to the Clinical Practice Research Datalink, a UK primary care database.Participants Each identified case (346 551) was matched for age, sex and general practice with 5 randomly selected control cases (1 732 755) with no diagnosis of SMI in each yearly time point.Outcome measures Prevalence rates were calculated for 16 conditions.Results SMI rates were highest in Scotland and in more deprived areas. Rates increased in England, Wales and Northern Ireland over time, with the largest increase in Northern Ireland (0.48% in 2000/2001 to 0.69% in 2011/2012). Annual prevalence rates of all conditions were higher in people with SMI compared with those without SMI. The discrepancy between the prevalence of those with and without SMI increased over time for most conditions. A greater increase in the mean number of additional conditions was observed in the SMI population over the study period (0.6 in 2000/2001 to 1.0 in 2011/2012) compared with those without SMI (0.5 in 2000/2001 to 0.6 in 2011/2012). For both groups, most conditions were more prevalent in more deprived areas, whereas for the SMI group conditions such as hypothyroidism, chronic kidney disease and cancer were more prevalent in more affluent areas.Conclusions Our findings highlight the health inequalities faced by people with SMI. The provision of appropriate timely health prevention, promotion and monitoring activities to reduce these health inequalities are needed, especially in deprived areas.https://bmjopen.bmj.com/content/5/12/e009010.full |
| spellingShingle | Tim Doran Darren M Ashcroft Evangelos Kontopantelis David Reeves Siobhan Reilly Claire Planner Ivan Olier Linda Gask Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK BMJ Open |
| title | Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK |
| title_full | Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK |
| title_fullStr | Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK |
| title_full_unstemmed | Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK |
| title_short | Inequalities in physical comorbidity: a longitudinal comparative cohort study of people with severe mental illness in the UK |
| title_sort | inequalities in physical comorbidity a longitudinal comparative cohort study of people with severe mental illness in the uk |
| url | https://bmjopen.bmj.com/content/5/12/e009010.full |
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