BACKGROUND: There is some concern that patients with mental illness may be in receipt of inferior medical care, including prescribed medication for medical conditions. AIMS: We aimed to quantify possible differences in the prescription of medication for medical conditions in those with v. without mental illness. METHOD: Systematic review and random effects meta-analysis with a minimum of three independent studies to warrant pooling by drug class. RESULTS: We found 61 comparative analyses (from 23 publications) relating to the prescription of 12 classes of medication for cardiovascular health, diabetes, cancer, arthritis, osteoporosis and HIV in a total sample of 1 931 509 people. In those with severe mental illness the adjusted odds ratio (OR) for an equitable prescription was 0.74 (95% CI 0.63-0.86), with lower than expected prescriptions for angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACE/ARBs), beta-blockers and statins. People with affective disorder had an odds ratio of 0.75 (95% CI 0.55-1.02) but this was not significant. Individuals with a history of other (miscellaneous) mental illness had an odds ratio of 0.95 (95% CI 0.92-0.98) of comparable medication with lower receipt of ACE/ARBs but not highly active antiretroviral therapy (HAART) medication. Results were significant in both adjusted and unadjusted analyses. CONCLUSIONS: Individuals with severe mental illness (including schizophrenia) appear to be prescribed significantly lower quantities of several common medications for medical disorders, largely for cardiovascular indications, although further work is required to clarify to what extent this is because of prescriber intent.
BACKGROUND: There is some concern that patients with mental illness may be in receipt of inferior medical care, including prescribed medication for medical conditions. AIMS: We aimed to quantify possible differences in the prescription of medication for medical conditions in those with v. without mental illness. METHOD: Systematic review and random effects meta-analysis with a minimum of three independent studies to warrant pooling by drug class. RESULTS: We found 61 comparative analyses (from 23 publications) relating to the prescription of 12 classes of medication for cardiovascular health, diabetes, cancer, arthritis, osteoporosis and HIV in a total sample of 1 931 509 people. In those with severe mental illness the adjusted odds ratio (OR) for an equitable prescription was 0.74 (95% CI 0.63-0.86), with lower than expected prescriptions for angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACE/ARBs), beta-blockers and statins. People with affective disorder had an odds ratio of 0.75 (95% CI 0.55-1.02) but this was not significant. Individuals with a history of other (miscellaneous) mental illness had an odds ratio of 0.95 (95% CI 0.92-0.98) of comparable medication with lower receipt of ACE/ARBs but not highly active antiretroviral therapy (HAART) medication. Results were significant in both adjusted and unadjusted analyses. CONCLUSIONS: Individuals with severe mental illness (including schizophrenia) appear to be prescribed significantly lower quantities of several common medications for medical disorders, largely for cardiovascular indications, although further work is required to clarify to what extent this is because of prescriber intent.
Authors: Marjan Javanbakht; Steven Shoptaw; Amy Ragsdale; Ron Brookmeyer; Robert Bolan; Pamina M Gorbach Journal: Drug Alcohol Depend Date: 2019-11-27 Impact factor: 4.492
Authors: Davy Vancampfort; Brendon Stubbs; Alex J Mitchell; Marc De Hert; Martien Wampers; Philip B Ward; Simon Rosenbaum; Christoph U Correll Journal: World Psychiatry Date: 2015-10 Impact factor: 49.548
Authors: Davy Vancampfort; Christoph U Correll; Britta Galling; Michel Probst; Marc De Hert; Philip B Ward; Simon Rosenbaum; Fiona Gaughran; John Lally; Brendon Stubbs Journal: World Psychiatry Date: 2016-06 Impact factor: 49.548