Cardiovascular risk assessment and management in mental health clients: whose role is it anyway?
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.
Wheeler
Amanda J
AJ
Clinical Research & Resource Centre, University of Auckland, New Zealand. amanda.wheeler@waitematadhb.govt.nz
Harrison
Jeff
J
Mohini
Priya
P
Nardan
Jeshika
J
Tsai
Amy
A
Tsai
Eve
E
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
Life Sci. 2002 Jun 7;71(3):239-57
12034344
Int J Clin Pract. 2007 Dec;61(12):1971-8
17997803
Pharmacopsychiatry. 2004 Sep;37(5):211-6
15470799
Am J Psychiatry. 1998 Dec;155(12):1775-7
9842793
Aust N Z J Psychiatry. 2003 Dec;37(6):710-4
14636386
BMJ. 2003 Apr 12;326(7393):793
12689976
Health Serv Res. 2003 Feb;38(1 Pt 1):41-63
12650380
Gen Hosp Psychiatry. 2006 Mar-Apr;28(2):145-53
16516065
Can J Psychiatry. 1991 May;36(4):239-45
1868416
Aust N Z J Psychiatry. 2005 Jan-Feb;39(1-2):1-30
15660702
Aust N Z J Psychiatry. 2001 Apr;35(2):196-202
11284901
Bipolar Disord. 2004 Oct;6(5):368-73
15383128
J Psychopharmacol. 2005 Nov;19(6 Suppl):94-101
16280342
Schizophr Res. 2008 Apr;101(1-3):256-65
18353616
Aust N Z J Psychiatry. 2006 Oct;40(10):882-8
16959014
Schizophr Res. 2007 Nov;96(1-3):215-22
17764906
Psychiatr Serv. 2002 Jul;53(7):861-7
12096170
Can J Psychiatry. 2008 Jan;53(1):34-42
18286870
N Z Med J. 2003 Dec 12;116(1187):U713
14752541
Arch Gen Psychiatry. 2001 Sep;58(9):844-50
11545667
J Affect Disord. 2002 Jun;70(1):19-26
12113916
Med Care. 2002 Feb;40(2):129-36
11802085
Am J Med. 2005 Apr;118 Suppl 2:15S-22S
15903291
Am Heart J. 2005 Dec;150(6):1115-21
16338246
Aust N Z J Psychiatry. 2007 Jul;41(7):606-10
17558623
J Nerv Ment Dis. 2004 Jun;192(6):421-7
15167405
BMC Psychiatry. 2006 Apr 21;6:16
16630335
Psychiatr Serv. 2007 Apr;58(4):536-43
17412857
Bipolar Disord. 2004 Aug;6(4):314-8
15225149
J Affect Disord. 1987 Nov-Dec;13(3):287-92
2960722
Br J Psychiatry. 1998 Jul;173:11-53
9850203
Med Care. 2003 Apr;41(4):560-70
12665719
Public Health. 2001 Sep;115(5):328-37
11593442
Psychiatr Serv. 2004 Nov;55(11):1250-7
15534013
Health Aff (Millwood). 2006 May-Jun;25(3):659-69
16684729
Arch Gen Psychiatry. 2008 Dec;65(12):1402-8
19047527