R Blackburn1, D Osborn2, K Walters3, I Nazareth4, I Petersen5. 1. Division of Psychiatry, W1T 7NF and Institute for Health Informatics, UCL, NW1 2DA, UK. Electronic address: r.blackburn@ucl.ac.uk. 2. Psychiatric Epidemiology, Division of Psychiatry, UCL, W1T 7NF and Camden and Islington NHS Foundation Trust, London NW1 0PE, UK. 3. Primary Care and Population Health, UCL, NW3 2PF, UK. 4. Primary Care and Population Health, UCL, NW3 2PF, UK; Primary Care and Population Science, Primary Care and Population Health, UCL, NW3 2PF, UK. 5. Primary Care and Population Health, UCL, NW3 2PF, UK; Epidemiology and Statistics, Primary Care and Population Health, UCL, NW3 2PF, Department of Clinical Epidemiology, Aarhus University, 8200 Aarhus N, Denmark.
Abstract
BACKGROUND: Severe mental illness (SMI) is associated with excess cardiovascular disease (CVD) morbidity, but little is known on provision of preventative interventions. We investigated statin initiation for primary CVD prevention in individuals with and without SMI. METHODS: We used primary care data from The Health Improvement Network from 2006 to 2015 for UK patients aged 30-99years with no pre-existing CVD conditions and selected individuals with schizophrenia (n=13,252) or bipolar disorder (n=11,994). In addition, we identified samples of individuals without schizophrenia (n=66,060) and bipolar disorder (n=59,765), but with similar age and gender distribution. Missing data on CVD covariates were estimated using multiple imputation. Statin prescribing differences between individuals with and without SMI were investigated using multivariable Poisson regression models. RESULTS: Initiation of statin prescribing was between 2 and 3 fold higher in people aged 30-59years with SMI than in those without after adjusting for CVD covariates. The rates in those aged 60-74years with SMI were similar or slightly higher relative to those without SMI. The incidence rate ratio (IRR) was 1.15 (95% CI 1.03-1.28) for bipolar disorder and 1.00 (0.91-1.11) for schizophrenia. The rate of statin prescribing was lower (IRR 0.81 (0.66-0.98)) amongst the oldest (aged 75+years) with schizophrenia relative to those without schizophrenia. CONCLUSIONS: Despite higher rates of new statin prescriptions to younger individuals with SMI relative to individuals without SMI, there was evidence of lower rates of statin initiation for older individuals with schizophrenia, and this group may benefit from additional measures to prevent CVD.
BACKGROUND: Severe mental illness (SMI) is associated with excess cardiovascular disease (CVD) morbidity, but little is known on provision of preventative interventions. We investigated statin initiation for primary CVD prevention in individuals with and without SMI. METHODS: We used primary care data from The Health Improvement Network from 2006 to 2015 for UK patients aged 30-99years with no pre-existing CVD conditions and selected individuals with schizophrenia (n=13,252) or bipolar disorder (n=11,994). In addition, we identified samples of individuals without schizophrenia (n=66,060) and bipolar disorder (n=59,765), but with similar age and gender distribution. Missing data on CVD covariates were estimated using multiple imputation. Statin prescribing differences between individuals with and without SMI were investigated using multivariable Poisson regression models. RESULTS: Initiation of statin prescribing was between 2 and 3 fold higher in people aged 30-59years with SMI than in those without after adjusting for CVD covariates. The rates in those aged 60-74years with SMI were similar or slightly higher relative to those without SMI. The incidence rate ratio (IRR) was 1.15 (95% CI 1.03-1.28) for bipolar disorder and 1.00 (0.91-1.11) for schizophrenia. The rate of statin prescribing was lower (IRR 0.81 (0.66-0.98)) amongst the oldest (aged 75+years) with schizophrenia relative to those without schizophrenia. CONCLUSIONS: Despite higher rates of new statin prescriptions to younger individuals with SMI relative to individuals without SMI, there was evidence of lower rates of statin initiation for older individuals with schizophrenia, and this group may benefit from additional measures to prevent CVD.
Authors: Iris E Sommer; Shiral S Gangadin; Lot D de Witte; Sanne Koops; C van Baal; Sabine Bahn; Hemmo Drexhage; N E M van Haren; Wim Veling; R Bruggeman; Peter Martens; Sybren Wiersma; Selene R T Veerman; Koen P Grootens; Nico van Beveren; Rene S Kahn; Marieke J H Begemann Journal: Schizophr Bull Date: 2021-07-08 Impact factor: 9.306
Authors: I H Heiberg; R Nesvåg; L Balteskard; J G Bramness; C M Hultman; Ø Naess; T Reichborn-Kjennerud; E Ystrom; B K Jacobsen; A Høye Journal: Acta Psychiatr Scand Date: 2020-02-29 Impact factor: 6.392
Authors: Sarah Hjorth; Anton Pottegård; Anne Broe; Caroline H Hemmingsen; Maarit K Leinonen; Marie Hargreave; Ulrika Nörby; Hedvig Nordeng Journal: Int J Epidemiol Date: 2022-06-13 Impact factor: 9.685
Authors: Alex Dregan; Ann McNeill; Fiona Gaughran; Peter B Jones; Anna Bazley; Sean Cross; Kate Lillywhite; David Armstrong; Shubulade Smith; David P J Osborn; Robert Stewart; Til Wykes; Matthew Hotopf Journal: PLoS One Date: 2020-03-27 Impact factor: 3.240