Osteoporosis referral and treatment among people with severe mental illness: A ten-year data linkage study

Ma, Ruimin; Romano, Eugenia; Davis, Katrina; Stewart, Robert; Ashworth, Mark; Vancampfort, Davy; Gaughran, Fiona; Stubbs, Brendon; Mueller, Christoph

doi:10.1016/j.jpsychires.2022.01.005

Journal of Psychiatric Research

2022

DOI: 10.1016/j.jpsychires.2022.01.005

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Osteoporosis referral and treatment among people with severe mental illness: A ten-year data linkage study

Ruimin Ma

Eugenia Romano

Katrina Davis

et al.

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2024

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Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data

Avgerinou,

Walters,

Bazo-Alvarez

et al. 2024

Br J Gen Pract

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Background: Severe Mental Illness (SMI) has been associated with reduced bone density and increased risk of fractures, although some studies have shown inconsistent results. Aim: Examine the association between SMI and recorded diagnosis of osteoporosis (OP) and fragility fracture (FF) in people aged ≥50years. Design and Setting: Population-based cohort study; UK Primary care. Method: We used anonymised primary care data (IQVIA Medical Research Database). Patients with a diagnosis of SMI aged 50-99y (2000-2018) were matched to individuals without SMI. We used Cox Proportional Hazards models to estimate Hazard Ratios (HR) and 95% Confidence Intervals (95%CI). We stratified analyses by sex and age, accounting for social deprivation, year, smoking, alcohol, and Body Mass Index (BMI). Results: In total 444,480 people were included (SMI N=50,006; unexposed N=394,474). In men, diagnosis of SMI increased the likelihood of OP diagnosis, with differences mainly observed amongst the youngest (50-54y:HR=2.12;95%CI 1.61-2.79) and oldest (85-99y:HR=2.15;95%CI 1.05-4.37), and also increased the risk of FF across all ages. In women, SMI increased the risk of OP diagnosis only in those aged 50-54y:HR=1.16;95%CI 1.01-1.34, but increased the risk of FF across all ages. There were more than twice as many men with SMI with FF records than with OP diagnosis: FF:OP=2.10, compared to FF:OP=1.89 in men without SMI. The FF:OP ratio was 1.56 in women with SMI vs.1.11 in women without SMI. Conclusion: SMI is associated with increased likelihood of fragility fractures and osteoporosis underdiagnosis. Interventions should be considered to mitigate the increased risk of fractures in people with SMI.

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Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data

Avgerinou,

Walters,

Bazo-Alvarez

et al. 2024

Br J Gen Pract

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show abstract

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Osteoporosis referral and treatment among people with severe mental illness: A ten-year data linkage study

Cited by 1 publication

References 46 publications

Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data

Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data

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