Screening for cardiovascular risk in patients with severe mental illness in primary care: A comparison with patients with diabetes

Abstract

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. Setting: five primary care centres in Northampton, England. Participants: 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.

Keywords:

• schizophrenia
• bipolar affective disorder
• cardiovascular disease
• screening
• primary care
• risk factors

Acknowledgements

Grateful thanks to all the people who participated in this audit.

Declaration of Interest: The first author has received honoraria from Lundbeck, Bristol-Myers Squibb, Otsuka Pharmceutical Europe Ltd, and educational support from Takeda, Jannsen Cilag and Novonordisk. The second author has no declarations of interest. Third has author provided consultancy work to AstraZeneca, Bristol-Myers Squibb, Jannsen Cilag, Eli Lilly and Co. Otsuka Pharmceutical Europe Ltd, Pfizer, received honoraria from AstraZeneca, Bristol-Myers Squibb, Jannsen Cilag, Eli Lilly and Co. Otsuka Pharmceutical Europe Ltd, Pfizer, Wyeth and had research support from AstraZeneca.