Dataset Information

Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study.

ABSTRACT:

Objectives

In order to address the substantial increased risk of cardiovascular disease among people with schizophrenia, it is necessary to identify the factors responsible for some of that increased risk. We analysed the extent to which these risk factors were documented in primary care electronic medical records (EMR), and compared their documentation by patient and provider characteristics.

Design

Retrospective cohort study.

Setting

EMR database of the University of Toronto Practice-Based Research Network Data Safe Haven.

Participants

197 129 adults between 40 and 75 years of age; 4882 with schizophrenia and 192 427 without.

Primary and secondary outcome measures

Documentation of cardiovascular disease risk factors (age, sex, smoking history, presence of diabetes, blood pressure, whether a patient is currently on medication to reduce blood pressure, total cholesterol and high-density lipoprotein cholesterol).

Results

Documentation of cardiovascular risk factors was more complete among people with schizophrenia (74.5% of whom had blood pressure documented at least once in the last 2 years vs 67.3% of those without, p>0.0001). Smoking status was not documented in 19.8% of those with schizophrenia and 20.8% of those without (p=0.0843). Factors associated with improved documentation included older patients (OR for ages 70-75 vs 45-49=3.51, 95% CI 3.26 to 3.78), male patients (OR=1.39, 95% CI 1.33 to 1.45), patients cared for by a female provider (OR=1.52, 95% CI 1.12 to 2.07) and increased number of encounters (OR for ≥10 visits vs 3-5 visits=1.53, 95% CI 1.46 to 1.60).

Conclusions

Documentation of cardiovascular risk factors was better among people with schizophrenia than without, although overall documentation was inadequate. Efforts to improve documentation of risk factors are warranted in order to facilitate improved management.

SUBMITTER: O'Neill B

PROVIDER: S-EPMC7569984 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study.

O'Neill Braden B Kalia Sumeet S Aliarzadeh Babak B Sullivan Frank F Moineddin Rahim R Kelly Martina M Greiver Michelle M

BMJ open 20201016 10

<h4>Objectives</h4>In order to address the substantial increased risk of cardiovascular disease among people with schizophrenia, it is necessary to identify the factors responsible for some of that increased risk. We analysed the extent to which these risk factors were documented in primary care electronic medical records (EMR), and compared their documentation by patient and provider characteristics.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>EMR database of the University of Toro ...[more]

PMID: 33067284

Similar Datasets

Project description:ObjectiveTo investigate how primary care access, intensity and quality of care changed among patients living with schizophrenia before and after the onset of the COVID-19 pandemic in Ontario, Canada.MethodsThis cohort study was performed using primary care electronic medical record data from the University of Toronto Practice-Based Research Network (UTOPIAN), a network of > 500 family physicians in Ontario, Canada. Data were collected during primary care visits from 2643 patients living with schizophrenia. Rates of primary care health service use (in-person and virtual visits with family physicians) and key preventive health indices indicated in antipsychotic monitoring (blood pressure readings, hemoglobin A1c, cholesterol and complete blood cell count [CBC] tests) were measured and compared in the 12 months before and after onset of the COVID-19 pandemic.ResultsAccess to in-person care dropped with the onset of the COVID-19 pandemic. During the first year of the pandemic only 39.5% of patients with schizophrenia had at least one in-person visit compared to 81.0% the year prior. There was a corresponding increase in virtual visits such that 78.0% of patients had a primary care appointment virtually during the pandemic period. Patients prescribed injectable antipsychotics were more likely to continue having more frequent in-person appointments during the pandemic than patients prescribed only oral or no antipsychotic medications. The proportion of patients who did not have recommended tests increased from 41.0% to 72.4% for blood pressure readings, from 48.9% to 60.2% for hemoglobin A1c, from 57.0% to 67.8% for LDL cholesterol and 45.0% to 56.0% for CBC tests during the pandemic.ConclusionsThere were substantial decreases in preventive care after the onset of the pandemic, although primary care access was largely maintained through virtual care. Addressing these deficiencies will be essential to promoting health equity and reducing the risk of poor health outcomes.

Dataset Information

Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study.

Similar Datasets

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