title: Inequalities in the provision of cardiovascular screening to people with severe mental illnesses in primary care: cohort study in the United Kingdom THIN Primary Care Database 2000-2007.
abstract: BACKGROUND
  People with severe mental illnesses (SMI), including schizophrenia, are at increased risk of cardiovascular disease (CVD). Guidelines recommend regular CVD screening and in the United Kingdom, since 2004, General Practitioners are remunerated for annual reviews.
  
  
  OBJECTIVE
  To compare annual rates of CVD screening provision in people with and without SMI between 2000 and 2008.
  
  
  METHODS
  We identified 18,696 people with SMI and 95,512 people without SMI in the UK The Health Improvement Network (THIN) primary care database. We compared the rates of measurement of blood pressure (BP), glucose, cholesterol and body mass index (BMI).
  
  
  RESULTS
  Prior to 2004, all people with SMI, were significantly less likely to receive each measurement, (including people above and below 60 years of age). In 2003; adjusted incidence rate ratios (95% CI) for screening in people with SMI under 60 years compared to people without SMI were: BMI: 0.62 (0.58-0.65); BP: 0.59 (0.56-0.62); glucose: 0.66 (0.61-0.70) and cholesterol: 0.54 (0.49-0.59). By 2007 people with SMI under 60 were equally likely receive a measurement of BMI: 1.00 (0.96-1.04), glucose: 1.00 (0.96-1.05) and cholesterol: 0.95 (0.90-1.0); the gap in screening for BP had narrowed 0.87 (0.83-0.90). However people with SMI over 60 years of age remained significantly less likely to be screened. There was little difference in screening according to social deprivation.
  
  
  CONCLUSIONS
  In UK primary care, people with SMI over 60 years of age remain less likely than the general population to receive annual CVD screening despite higher risk of developing CVD.
authors.affiliation: Department of Mental Health Sciences, Royal Free Campus, University College London Medical School, Rowland Hill Street, London, NW3 2PF, UK. d.osborn@ucl.ac.uk
authors.forename: David P J
authors.initials: DP
authors.lastname: Osborn
authors.forename: Gianluca
authors.initials: G
authors.lastname: Baio
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
authors.forename: Heather
authors.initials: H
authors.lastname: Limburg
authors.forename: Rosalind
authors.initials: R
authors.lastname: Raine
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
mesh_terms: D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D002784:Cholesterol; D015331:Cohort Studies; D005260:Female; D058005:General Practitioners; D006339:Heart Rate; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000453:epidemiology*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D002784:Cholesterol