title: Cardiovascular risk assessment and management in mental health clients: whose role is it anyway?
abstract: People with serious mental illness have higher rates of morbidity and mortality from cardiovascular disease. This study describes health practitioners' views on their role and confidence assessing and managing cardiovascular risk. The key findings were of a widespread acknowledgement of the need to undertake systematic risk assessment and offer structured approaches to risk factor management. Barriers of client engagement, lack of good systems and poor information sharing between primary and secondary care providers were identified. Solutions discussed included a collaborative care model or the integration of physical health services, perhaps a general practitioner-led clinic, within the secondary care setting. Whilst there is a need to identify an optimal care model there is an even greater need to take some rather than no action.
authors.affiliation: Clinical Research & Resource Centre, University of Auckland, New Zealand. amanda.wheeler@waitematadhb.govt.nz
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Wheeler
authors.forename: Jeff
authors.initials: J
authors.lastname: Harrison
authors.forename: Priya
authors.initials: P
authors.lastname: Mohini
authors.forename: Jeshika
authors.initials: J
authors.lastname: Nardan
authors.forename: Amy
authors.initials: A
authors.lastname: Tsai
authors.forename: Eve
authors.initials: E
authors.lastname: Tsai
mesh_terms: D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000150:complications* / Q000628:therapy*; D003142:Communication; D003299:Cooperative Behavior; D019468:Disease Management; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D009520:New Zealand; D024382:Professional Role; D036301:Qualitative Research; D018570:Risk Assessment; D012308:Risk Management
references.citation: Life Sci. 2002 Jun 7;71(3):239-57
references.pmid: 12034344
references.citation: Int J Clin Pract. 2007 Dec;61(12):1971-8
references.pmid: 17997803
references.citation: Pharmacopsychiatry. 2004 Sep;37(5):211-6
references.pmid: 15470799
references.citation: Am J Psychiatry. 1998 Dec;155(12):1775-7
references.pmid: 9842793
references.citation: Aust N Z J Psychiatry. 2003 Dec;37(6):710-4
references.pmid: 14636386
references.citation: BMJ. 2003 Apr 12;326(7393):793
references.pmid: 12689976
references.citation: Health Serv Res. 2003 Feb;38(1 Pt 1):41-63
references.pmid: 12650380
references.citation: Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):145-53
references.pmid: 16516065
references.citation: Can J Psychiatry. 1991 May;36(4):239-45
references.pmid: 1868416
references.citation: Aust N Z J Psychiatry. 2005 Jan-Feb;39(1-2):1-30
references.pmid: 15660702
references.citation: Aust N Z J Psychiatry. 2001 Apr;35(2):196-202
references.pmid: 11284901
references.citation: Bipolar Disord. 2004 Oct;6(5):368-73
references.pmid: 15383128
references.citation: J Psychopharmacol. 2005 Nov;19(6 Suppl):94-101
references.pmid: 16280342
references.citation: Schizophr Res. 2008 Apr;101(1-3):256-65
references.pmid: 18353616
references.citation: Aust N Z J Psychiatry. 2006 Oct;40(10):882-8
references.pmid: 16959014
references.citation: Schizophr Res. 2007 Nov;96(1-3):215-22
references.pmid: 17764906
references.citation: Psychiatr Serv. 2002 Jul;53(7):861-7
references.pmid: 12096170
references.citation: Can J Psychiatry. 2008 Jan;53(1):34-42
references.pmid: 18286870
references.citation: N Z Med J. 2003 Dec 12;116(1187):U713
references.pmid: 14752541
references.citation: Arch Gen Psychiatry. 2001 Sep;58(9):844-50
references.pmid: 11545667
references.citation: J Affect Disord. 2002 Jun;70(1):19-26
references.pmid: 12113916
references.citation: Med Care. 2002 Feb;40(2):129-36
references.pmid: 11802085
references.citation: Am J Med. 2005 Apr;118 Suppl 2:15S-22S
references.pmid: 15903291
references.citation: Am Heart J. 2005 Dec;150(6):1115-21
references.pmid: 16338246
references.citation: Aust N Z J Psychiatry. 2007 Jul;41(7):606-10
references.pmid: 17558623
references.citation: J Nerv Ment Dis. 2004 Jun;192(6):421-7
references.pmid: 15167405
references.citation: BMC Psychiatry. 2006 Apr 21;6:16
references.pmid: 16630335
references.citation: Psychiatr Serv. 2007 Apr;58(4):536-43
references.pmid: 17412857
references.citation: Bipolar Disord. 2004 Aug;6(4):314-8
references.pmid: 15225149
references.citation: J Affect Disord. 1987 Nov-Dec;13(3):287-92
references.pmid: 2960722
references.citation: Br J Psychiatry. 1998 Jul;173:11-53
references.pmid: 9850203
references.citation: Med Care. 2003 Apr;41(4):560-70
references.pmid: 12665719
references.citation: Public Health. 2001 Sep;115(5):328-37
references.pmid: 11593442
references.citation: Psychiatr Serv. 2004 Nov;55(11):1250-7
references.pmid: 15534013
references.citation: Health Aff (Millwood). 2006 May-Jun;25(3):659-69
references.pmid: 16684729
references.citation: Arch Gen Psychiatry. 2008 Dec;65(12):1402-8
references.pmid: 19047527