Screening for cardiovascular risk in patients with severe mental illness in primary care: a comparison with patients with diabetes.
BACKGROUND
People with severe mental illness (SMI) have a higher risk of developing cardiovascular disease (CVD) compared with the general population. Clinical guidelines recommend annual screening for CVD risk factors with appropriate lifestyle counselling. Aims To establish the proportion of patients with SMI being screened for CVD risk factors in their primary care practice compared with those with diabetes and determine whether people with SMI receive lifestyle advice. METHOD DESIGN: a retrospective audit.


METHODS
five primary care centres in Northampton, England.


METHODS
three hundred and eighty-six patients with SMI and 1875 with diabetes.


RESULTS
Just over a fifth of patients with SMI received a full CVD screen compared with the 96% of those with diabetes (OR  =  90.37; 95% CI  =  64.53-126.55, p  <  0.01). Fifty-seven per cent of the SMI patients were given smoking advice but only 13% and 14% received guidance regarding diet and exercise, respectively. On average of each patient with SMI received fewer than two (from four) screening interventions and less than one (from three) components of lifestyle advice.


CONCLUSIONS
In primary care, the number of people with SMI receiving screening for CVD risk is much lower than those with diabetes.
Park Avenue Medical Centre, 168 Park Avenue North, Northampton NN3 2HZ , UK. sa.hardy@btinternet.com
Sheila
S
Hardy
Philippa
P
Hinks
Richard
R
Gray
D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D048909:Diabetes Complications / Q000175:diagnosis*; D004739:England; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors