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Prevalence and patient characteristics associated with cardiovascular disease risk factor screening in UK primary care for people with severe mental illness: an electronic healthcare record study

Naomi Launders Orcid Logo, Caroline Anne Jackson Orcid Logo, Joseph F Hayes Orcid Logo, Ann John Orcid Logo, Robert Stewart Orcid Logo, Matthew H Iveson Orcid Logo, Elvira Bramon Orcid Logo, Bruce Guthrie Orcid Logo, Stewart William Mercer Orcid Logo, David P J Osborn Orcid Logo

BMJ Mental Health, Volume: 28, Issue: 1, Start page: e301409

Swansea University Author: Ann John Orcid Logo

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DOI (Published version): 10.1136/bmjment-2024-301409

Abstract

Background: People with severe mental illness (SMI) are at increased risk of cardiovascular disease (CVD), and initiatives for CVD risk factor screening in the UK have not reduced disparities. Objectives: To describe the annual screening prevalence for CVD risk factors in people with SMI from April...

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Published in: BMJ Mental Health
ISSN: 2755-9734
Published: BMJ Publishing Group Ltd 2025
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa70076
Abstract: Background: People with severe mental illness (SMI) are at increased risk of cardiovascular disease (CVD), and initiatives for CVD risk factor screening in the UK have not reduced disparities. Objectives: To describe the annual screening prevalence for CVD risk factors in people with SMI from April 2000 to March 2018, and to identify factors associated with receiving no screening and regular screening. Methods: We identified adults with a diagnosis of SMI (schizophrenia, bipolar disorder or ‘other psychosis’) from UK primary care records in Clinical Practice Research Datalink. We calculated the annual prevalence of screening for blood pressure, cholesterol, glucose, body mass index, alcohol consumption and smoking status using multinomial logistic regression to identify factors associated with receiving no screening and complete screening. Results: Of 216 136 patients with SMI, 55% received screening for all six CVD risk factors at least once during follow-up and 35% received all six within a 1-month period. Our findings suggest that patient characteristics and financial incentivisation influence screening prevalence of individual CVD risk factors, the likelihood of receiving screening for all six CVD risk factors annually and risk of receiving no screening. Conclusions: The low proportion of people with SMI receiving regular comprehensive CVD risk factor screening is concerning. Screening needs to be embedded as part of broad physical health checks to ensure the health needs of people with SMI are being met. If we are to improve cardiovascular health, interventions are needed where risk of receiving no screening or not receiving regular screening is highest.
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was funded by the UK Research and Innovation grant (MR/W014386/1) as part of the Health Data Research (HDR) UK DATAMIND hub. NL, JFH, MHI, EB, RS, AJ and DPJO acknowledge funding from DATAMIND through this grant. NL is supported by an HDR UK personal fellowship (Big Data for Complex Disease driver programme: HDR-23012). This work is affiliated to HDR UK which is funded by the Medical Research Council (UKRI), the National Institute for Health Research, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council (UKRI), the Engineering and Physical Sciences Research Council (UKRI), Health and Care Research Wales, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, and Health and Social Care Research and Development Division (Public Health Agency, Northern Ireland). NL and JFH are additionally supported by the UK Research and Innovation grant (MR/V023373/1). NL, JFH, EB and DPJO are supported by the NIHR University College London Hospitals Biomedical Research Centre. NL, JFH and DPJO are supported by the NIHR North Thames Applied Research Collaboration. RS is additionally part funded by the NIHR Maudsley Biomedical Research Centre; the NIHR Applied Research Collaboration South London; the UK Prevention Research Partnership (Violence, Health and Society; MR-VO49879/1), an initiative funded by the UK Research and Innovation Councils, the Department of Health and Social Care (England) and the UK devolved administrations, and leading health research charities. MHI is additionally supported by the Wellcome Trust (220857/Z/20/Z; 226770/Z/22/Z; 104036/Z/14/Z; 216767/Z/19/Z) and by a Research Data Scotland Accelerator Award (RAS-24-2). EB acknowledges the additional support of Medical Research Council (G1100583, MR/W020238/1), National Institute of Health Research (NIHR200756), Mental Health Research UK–John Grace QC Scholarship 2018, Economic Social Research Council’s Co-funded doctoral award, the British Medical Association’s Margaret Temple Fellowship, Medical Research Council New Investigator and Centenary Awards (G0901310, G1100583).
Issue: 1
Start Page: e301409

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