Differences in the primary care management of patients with psychosis from two ethnic groups: a population-based cross-sectional study

Pinto, Rebecca; Ashworth, Mark; Seed, Paul; Rowlands, Gill; Schofield, Peter; Jones, Roger

doi:10.1093/fampra/cmq014

Cited by 17 publications

(32 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Non-white ethnicity is also an established risk factor for SMI [21]. The prevalence of SMI found in the current study (1.4%), is slightly higher than that reported previously for the Lambeth primary care population (1.0%, Pinto et al [21]).…”

Section: Discussioncontrasting

confidence: 66%

Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study

et al. 2014

View full text Add to dashboard Cite

BackgroundSerious mental illness (SMI) is associated with elevated mortality compared to the general population; the majority of this excess is attributable to co-occurring common physical health conditions. There may be variation within the SMI group in the distribution of physical co/multi-morbidity. This study aims to a) compare the pattern of physical co- and multi-morbidity between patients with and without SMI within a South London primary care population; and, b) to explore socio-demographic and health risk factors associated with excess physical morbidity among the SMI group.MethodsData were obtained from Lambeth DataNet, a database of electronic patient records derived from general practices in the London borough of Lambeth. The pattern of 12 co-morbid common physical conditions was compared by SMI status. Multivariate ordinal and logistic regression analyses were conducted to assess the strength of association between each condition and SMI status; adjustments were made for potentially confounding socio-demographic characteristics and for potentially mediating health risk factors.ResultsWhile SMI patients were more frequently recorded with all 12 physical conditions than non-SMI patients, the pattern of co-/multi-morbidity was similar between the two groups. Adjustment for socio-demographic characteristics – in particular age and, to a lesser extent ethnicity, considerably reduced effect sizes and accounted for some of the associations, though several conditions remained strongly associated with SMI status. Evidence for mediation by health risk factors, in particular BMI, was supported.ConclusionsSMI patients are at an elevated risk of a range of physical health conditions than non-SMI patients but they do not appear to experience a different pattern of co-/multimorbidity among those conditions considered. Socio-demographic differences between the two groups account for some of the excess in morbidity and known health risk factors are likely to mediate the association. Further work to examine a wider range of conditions and health risk factors would help determine the extent of excess mortality attributable to these factors.

show abstract

Section: Discussioncontrasting

confidence: 66%

Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…One of the key factors that limits the clinical effectiveness of treatment of psychotic disorders with oral antipsychotic medication is poor adherence. Although long-acting injectable (LAI) antipsychotics may provide a means of overcoming this problem (Tiihonen et al 2011 ; Marcus et al 2015 ), a minority of patients prescribed antipsychotics (typically about 12% of the population investigated in the present study) (Pinto et al 2010 ) are treated with LAIs. This may reflect patients being less willing to be treated via an intramuscular injection, and concerns about stigmatization, adverse effects and limiting patient autonomy (Johnson, 2009 ), concerns that may be shared by the prescribing clinician.…”

Section: Introductionmentioning

confidence: 92%

Is paliperidone palmitate more effective than other long-acting injectable antipsychotics?

et al. 2017

View full text Add to dashboard Cite

BackgroundPaliperidone palmitate is one of the most widely prescribed long-acting injectable (LAI) antipsychotics in the UK. However, it is relatively expensive and there are few data comparing its effectiveness to that of other LAI antipsychotics. We sought to address this issue by analyzing a large anonymized electronic health record (EHR) dataset from patients treated with LAI antipsychotics.MethodsEHR data were obtained from 1281 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who started treatment with a LAI antipsychotic between 1 April 2011 and 31 January 2015. The number of days spent as a psychiatric inpatient and the number of admissions to a psychiatric hospital were analyzed in each of the 3 years before and after LAI prescription.ResultsPatients treated with paliperidone palmitate (n = 430; 33.6%) had a greater number of inpatient days and a greater number of admissions in the year prior to treatment than those treated with other LAI antipsychotics. Nevertheless, in the 3 years after initiation there were no significant differences between paliperidone and the other LAI antipsychotics in the number of days as an inpatient (B coefficient 5.4 days, 95% confidence interval (CI) −57.3 to 68.2, p = 0.86) or number of hospital admissions (Incidence rate ratio 1.07, 95% CI 0.62 to 1.83, p = 0.82).ConclusionPaliperidone palmitate was more likely to be prescribed in patients with more frequent and lengthy hospital admissions prior to initiation. However, the absence of differences in outcomes after initiation indicates that paliperidone palmitate was not more effective than other cheaper LAI antipsychotics.

show abstract

“…This borough in south-east London has the second highest proportion of census-defined ‘black or black British’ residents in the UK at 25.8% (neighbouring Southwark has the highest proportion at 25.9%) 12. The database was originally set up to improve both the level and quality of ethnicity coding in GP data and therefore has a high level of ethnicity coding 13 14…”

Section: Methodsmentioning

confidence: 99%

Methods for assessing cardiovascular disease risk in a UK black population

Schofield

Chen

Crichton

2012

Heart

View full text Add to dashboard Cite

show abstract

Differences in the primary care management of patients with psychosis from two ethnic groups: a population-based cross-sectional study

Abstract: Measurable aspects of physical health care of patients with psychosis were similar, regardless of ethnicity. Increased use of the depot antipsychotic medication in black patients needs further exploration.

Cited by 17 publications

References 29 publications

Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study

Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study

Is paliperidone palmitate more effective than other long-acting injectable antipsychotics?

Methods for assessing cardiovascular disease risk in a UK black population

Contact Info

Product

Resources

About