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背景对患有心血管疾病(CVD)的严重精神疾病(SMI)患者行欠佳治疗会导致其身体健康差异。目的分析与CVD治疗和预防指南相关的SMI的特点。设计与场所伦敦东南部及英国初级保健和二级精神卫生服务的唯一供应者之间的基于人口的电子健康记录数据库。方法采用多元Logistic回归分析模型,对比4 056例SMI患者(其记录已与二级医疗记录相关联)和270 669例非SMI患者(不熟知二级护理精神病医疗服务)的CVD患病率、风险因素、质量和结果框架(QOF)临床目标结果。结果患有冠心病和心力衰竭的SMI患者,其含有β-受体阻滞剂和血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂(ACEI/ARB)的处方减少。精神分裂症由其危险因素指标或疾病严重程度确定,通过抗精神病药物注射处方进行治疗,其诊断与所开处方的关系不大。结论初级和二级保健数据的连接为发现大部分处于身体健康问题治疗不足风险的SMI患者提供可能。
Background Suboptimal treatment of patients with severe mental illness (SMI) who have cardiovascular disease (CVD) can result in differences in their health. Objective To analyze the characteristics of SMI associated with CVD guidelines for treatment and prevention. Design and Location Population-based electronic health record database between South East London and the UK’s sole provider of primary and secondary mental health services. Methods A multivariate Logistic regression model was used to compare CVD prevalence in 4,056 SMI patients whose records were associated with secondary medical records and 270,669 non-SMI patients who were not familiar with secondary care psychiatric services, Factors, Quality and Outcomes Framework (QOF) Clinical Outcomes. Results SMI patients with coronary heart disease and heart failure had a reduced prescribing of beta-blockers and angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEI / ARB). Schizophrenia is determined by its risk factors or the severity of the illness. Treatment with an antipsychotic injection has little to do with the diagnosis. Conclusions The connection of primary and secondary health data offers the possibility of finding most SMI patients at risk of under-treatment of health problems.