Continuity of care and mortality in people with schizophrenia
Background People with schizophrenia have shortened lives. This excess mortality seems to be related to physical health conditions that may be amenable to better primary and secondary prevention. Better continuity of care may enhance such interventions as well as help prevent death by self-injury....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-07-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421009650/type/journal_article |
| _version_ | 1811156928701661184 |
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| author | Alastair Macdonald Dimitrios Adamis Matthew Broadbent Tom Craig Rob Stewart Robin M. Murray |
| author_facet | Alastair Macdonald Dimitrios Adamis Matthew Broadbent Tom Craig Rob Stewart Robin M. Murray |
| author_sort | Alastair Macdonald |
| collection | DOAJ |
| description |
Background
People with schizophrenia have shortened lives. This excess mortality seems to be related to physical health conditions that may be amenable to better primary and secondary prevention. Better continuity of care may enhance such interventions as well as help prevent death by self-injury.
Aims
We set out to examine the relationship between the continuity of care of patients with schizophrenia, their mortality and cause of death.
Method
Pseudoanonymised community data from 5551 people with schizophrenia presenting over 11 years were examined for changes in continuity of care using the numbers of community teams caring for them and the Modified Modified Continuity Index. These and demographic variables were related to death certifications of physical illness from the Office of National Statistics and mortal self-injury from clinical data. Data were analysed using generalised estimating equations.
Results
We found no independent relationship between levels of continuity of care and overall mortality. However, lower levels of relationship continuity were significantly and independently related to death by self-injury.
Conclusions
We found no evidence that continuity of care is important in the prevention of physical causes of death in schizophrenia. However, there is evidence that declining relationship continuity of care has an independent effect on deaths as a result of self-injury. We suggest that there should be more attention focused on the improvement of continuity of care for these patients.
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| first_indexed | 2024-04-10T04:59:22Z |
| format | Article |
| id | doaj.art-995a7356272b4341931875683ce1e56f |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:22Z |
| publishDate | 2021-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-995a7356272b4341931875683ce1e56f2023-03-09T12:29:07ZengCambridge University PressBJPsych Open2056-47242021-07-01710.1192/bjo.2021.965Continuity of care and mortality in people with schizophreniaAlastair Macdonald0https://orcid.org/0000-0001-8142-1875Dimitrios Adamis1Matthew Broadbent2Tom Craig3https://orcid.org/0000-0003-1442-0391Rob Stewart4https://orcid.org/0000-0002-4435-6397Robin M. Murray5National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UKSt. Columba's Hospital, EireNIHR Maudsley Biomedical Research Centre, UK(Emeritus) Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKInstitute of Psychiatry, Psychology and Neuroscience, King's College London, UKInstitute of Psychiatry, Psychology and Neuroscience, King's College London, UK Background People with schizophrenia have shortened lives. This excess mortality seems to be related to physical health conditions that may be amenable to better primary and secondary prevention. Better continuity of care may enhance such interventions as well as help prevent death by self-injury. Aims We set out to examine the relationship between the continuity of care of patients with schizophrenia, their mortality and cause of death. Method Pseudoanonymised community data from 5551 people with schizophrenia presenting over 11 years were examined for changes in continuity of care using the numbers of community teams caring for them and the Modified Modified Continuity Index. These and demographic variables were related to death certifications of physical illness from the Office of National Statistics and mortal self-injury from clinical data. Data were analysed using generalised estimating equations. Results We found no independent relationship between levels of continuity of care and overall mortality. However, lower levels of relationship continuity were significantly and independently related to death by self-injury. Conclusions We found no evidence that continuity of care is important in the prevention of physical causes of death in schizophrenia. However, there is evidence that declining relationship continuity of care has an independent effect on deaths as a result of self-injury. We suggest that there should be more attention focused on the improvement of continuity of care for these patients. https://www.cambridge.org/core/product/identifier/S2056472421009650/type/journal_articleMortalityschizophreniadeliberate self-harmoutcome studiessuicide |
| spellingShingle | Alastair Macdonald Dimitrios Adamis Matthew Broadbent Tom Craig Rob Stewart Robin M. Murray Continuity of care and mortality in people with schizophrenia BJPsych Open Mortality schizophrenia deliberate self-harm outcome studies suicide |
| title | Continuity of care and mortality in people with schizophrenia |
| title_full | Continuity of care and mortality in people with schizophrenia |
| title_fullStr | Continuity of care and mortality in people with schizophrenia |
| title_full_unstemmed | Continuity of care and mortality in people with schizophrenia |
| title_short | Continuity of care and mortality in people with schizophrenia |
| title_sort | continuity of care and mortality in people with schizophrenia |
| topic | Mortality schizophrenia deliberate self-harm outcome studies suicide |
| url | https://www.cambridge.org/core/product/identifier/S2056472421009650/type/journal_article |
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