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dc.contributor.authorO’Neill, Braden
dc.contributor.authorKalia, Sumeet
dc.contributor.authorAliarzadeh, Babak
dc.contributor.authorSullivan, Frank
dc.contributor.authorMoineddin, Rahim
dc.contributor.authorKelly, Martina
dc.contributor.authorGreiver, Michelle
dc.date.accessioned2020-10-22T10:30:01Z
dc.date.available2020-10-22T10:30:01Z
dc.date.issued2020-10-16
dc.identifier270807635
dc.identifierf3269804-9f6d-481f-9a48-7616545ac6b2
dc.identifier85093705719
dc.identifier000585737900014
dc.identifier33067284
dc.identifier.citationO’Neill , B , Kalia , S , Aliarzadeh , B , Sullivan , F , Moineddin , R , Kelly , M & Greiver , M 2020 , ' Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada : retrospective cohort study ' , BMJ Open , vol. 10 , no. 10 , e038013 . https://doi.org/10.1136/bmjopen-2020-038013en
dc.identifier.issn2044-6055
dc.identifier.otherRIS: urn:C557AAEC19D947343F49D80DA6616913
dc.identifier.otherORCID: /0000-0002-6623-4964/work/82501044
dc.identifier.urihttps://hdl.handle.net/10023/20810
dc.descriptionThis study was funded by the Foundation for Advancing Family Medicine of the College of Family Physicians of Canada (2018 Janus Research Grant). BO completed this work during a Research Fellowship with the Medical Psychiatry Alliance, Toronto, Ontario. BO and MG receive salary support from North York General Hospital and the Department of Family and Community Medicine, University of Toronto, Ontario, Canada.en
dc.description.abstractObjectives 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.  P articipants 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.
dc.format.extent9
dc.format.extent651129
dc.language.isoeng
dc.relation.ispartofBMJ Openen
dc.subjectCardiologyen
dc.subjectHealth informaticsen
dc.subjectMental healthen
dc.subjectPreventive medicineen
dc.subjectPrimary careen
dc.subjectSchizophrenia & psychotic disordersen
dc.subjectRC0321 Neuroscience. Biological psychiatry. Neuropsychiatryen
dc.subjectZA4050 Electronic information resourcesen
dc.subjectDASen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.subject.lccRC0321en
dc.subject.lccZA4050en
dc.titleCardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada : retrospective cohort studyen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.identifier.doi10.1136/bmjopen-2020-038013
dc.description.statusPeer revieweden


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