Demographic and health profiles of people with severe mental illness in general practice in Australia: a cross-sectional study
Catherine Spooner
A * , Samira Afrazi B , Juliana de Oliveira Costa C and Mark F. Harris A
+ Author Affiliations
- Author Affiliations
A Centre for Primary Health Care and Equity (CPHCE), Faculty of Medicine, UNSW Sydney, High Street, Kensington, NSW 2052, Australia.
B CPHCE/CBDRH, Faculty of Medicine, UNSW Sydney, High Street, Kensington, NSW 2052, Australia.
C Centre for Big Data Research in Health (CBDRH), Faculty of Medicine, UNSW Sydney, High Street, Kensington, NSW 2052, Australia.
* Correspondence to: c.spooner@unsw.edu.au
Australian Journal of Primary Health 28(5) 408-416 https://doi.org/10.1071/PY21240
Submitted: 19 October 2021 Accepted: 21 March 2022 Published: 2 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY).
Abstract
Background: People with severe mental illness have a higher rate of premature death than the general population, largely due to primary care preventable diseases. There has been little research on the health profile of this population attending Australian general practices.
Methods: In this nationwide cross-sectional study, MedicineInsight data for adult patients regularly attending general practices in 2018 were analysed to estimate the prevalence of schizophrenia or bipolar disorders (SBD) and investigate the health profile of people with SBD compared with other patients. Multilevel models clustered by practice (n = 565) and patient, and practice characteristics were created.
Results: The prevalence of recorded SBD was 1.91% (95% CI = 1.88%–1.94%) among the 618 849 patients included. Patients with recorded SBD were more likely than other patients to have records of health risk factors, particularly smoking (aOR = 3.8, 95% CI = 3.6–3.9) and substance use (aOR = 5.9, 95% CI = 5.6–6.3), and higher probabilities of comorbidities including cardiovascular diseases (aOR = 1.3, 95% CI = 1.2–1.4), cancer (aOR = 1.1, 95% CI = 1.0–1.2), diabetes mellitus type 2 (aOR = 2.2, 95% CI = 2.0–2.3), chronic kidney diseases (aOR = 1.7, 95% CI = 1.5–2.0), chronic liver diseases (aOR = 3.3, 95% CI = 2.6–4.0) and chronic respiratory diseases (aOR = 1.7, 95% CI = 1.7–1.8).
Conclusions: The higher prevalence of health risk factors and comorbidities among patients with recorded SBD underscores the need for proactive health risk monitoring and preventive care to address this health inequity.
Keywords: bipolar disorder, chronic diseases, comorbidity, general practice, health inequality, preventive health, schizophrenia, severe mental illness.
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