title: Cardiovascular Disease Mortality of Medicaid Clients with Severe Mental Illness and a Co-occurring Substance Use Disorder.
abstract: Increasing attention focuses on cardiovascular disease (CVD) among persons with SMI. We examined, among persons with SMI, whether co-occurring substance use disorder (SUD) elevates the risk of CVD death. We linked 2002-2007 Medicaid claims data on 121,817 persons with SMI to cause and date of death information. We applied a proportional hazards model that controls for co-morbidity at baseline, atypical antipsychotic prescription medications, age, gender and race/ethnicity. Results among persons with co-occurring SUD indicate a 24 % increased risk of CVD death (hazard ratio 1.24; 95 % confidence interval 1.17-1.33). We encourage further coordination of services for this population.
authors.affiliation: Program in Public Health, University of California, Irvine, 635 E. Peltason Drive, Irvine, CA, 92697-3957, USA. tim.bruckner@uci.edu.
authors.forename: Tim A
authors.initials: TA
authors.lastname: Bruckner
authors.affiliation: Department of Health Policy and Management, Oregon State University, Corvallis, OR, USA.
authors.forename: Jangho
authors.initials: J
authors.lastname: Yoon
authors.affiliation: School of Pharmacy, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Marco
authors.initials: M
authors.lastname: Gonzales
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Cardiovascular death; Comorbidity; Severe mental illness; Substance use