Final published version, 1.36 MB, PDF document
Available under license: CC BY: Creative Commons Attribution 4.0 International License
Final published version
Licence: CC BY: Creative Commons Attribution 4.0 International License
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Inequalities in physical comorbidity
T2 - a longitudinal comparative cohort study of people with severe mental illness in the UK
AU - Reilly, Siobhan
AU - Olier, Ivan
AU - Planner, Claire
AU - Doran, Tim
AU - Reeves, David
AU - Ashcroft, Darren M.
AU - Gask, Linda
AU - Kontopantelis, Evangelos
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
PY - 2015/12/17
Y1 - 2015/12/17
N2 - 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.
AB - 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.
KW - severe men, mental health, physical health, comorbidity, clinical practice research datalinktal illness
KW - mental health
KW - physical health
KW - comorbidity
KW - CPRD
KW - clinical practice research datalink
KW - epidemiology
U2 - 10.1136/bmjopen-2015-009010
DO - 10.1136/bmjopen-2015-009010
M3 - Journal article
C2 - 26671955
VL - 5
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 12
M1 - e009010
ER -