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Screening for cardiovascular risk factors in adults with serious mental illness: a review of the evidence.

Baller JB, McGinty EE, Azrin ST, Juliano-Bult D, Daumit GL - BMC Psychiatry (2015)

Bottom Line: For example, rates of lipid testing for antipsychotic users ranged from 6% to 85%.For some conditions, rates of screening were consistently high.For example, screening rates for hypertension ranged from 79% - 88%.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N Broadway St., Room 405, Baltimore, MD, 21205, USA. jballer@jhu.edu.

ABSTRACT

Background: Adults with serious mental illness have a mortality rate two to three times higher than the overall US population, much of which is due to somatic conditions, especially cardiovascular disease. Given the disproportionately high prevalence of cardiovascular risk factors in the population with SMI, screening for these conditions is an important first step for timely diagnosis and appropriate treatment. This comprehensive literature review summarizes screening rates for cardiovascular risk factors in the population with serious mental illness.

Methods: Relevant articles published between 2000 and 2013 were identified using the EMBASE, PsychInfo, PubMed, SCOPUS and Web of Science databases. We reviewed 10 studies measuring screening rates for obesity, diabetes, dyslipidemia, and hypertension in the population with serious mental illness. Two reviewers independently extracted information on screening rates, study population, and study setting.

Results: Rates of screening varied considerably by time period, study population, and data source for all medical conditions. For example, rates of lipid testing for antipsychotic users ranged from 6% to 85%. For some conditions, rates of screening were consistently high. For example, screening rates for hypertension ranged from 79% - 88%.

Conclusions: There is considerable variation in screening of cardiovascular risk factors in the population with serious mental illness, with significant need for improvement in some study populations and settings. Implementation of standard screening protocols triggered by diagnosis of serious mental illness or antipsychotic use may be promising avenues for ensuring timely diagnosis and treatment of cardiovascular risk factors in this population.

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Related in: MedlinePlus

PRISMA flow diagram, included studies.
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Related In: Results  -  Collection

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Fig1: PRISMA flow diagram, included studies.

Mentions: Our search yielded a total of 136 studies (FigureĀ 1). One hundred twenty-six studies were excluded for failure to meet inclusion criteria; in this category, most studies were excluded for not having an outcome measure of interest. A total of 10 studies were included in our review. Included studies measured screening rates for overweight and obesity, diabetes mellitus, dyslipidemia, and hypertension. While we also searched for studies measuring rates of screening for tobacco use in the population with SMI, no studies measuring this outcome that met our inclusion criteria were identified.Figure 1


Screening for cardiovascular risk factors in adults with serious mental illness: a review of the evidence.

Baller JB, McGinty EE, Azrin ST, Juliano-Bult D, Daumit GL - BMC Psychiatry (2015)

PRISMA flow diagram, included studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4376086&req=5

Fig1: PRISMA flow diagram, included studies.
Mentions: Our search yielded a total of 136 studies (FigureĀ 1). One hundred twenty-six studies were excluded for failure to meet inclusion criteria; in this category, most studies were excluded for not having an outcome measure of interest. A total of 10 studies were included in our review. Included studies measured screening rates for overweight and obesity, diabetes mellitus, dyslipidemia, and hypertension. While we also searched for studies measuring rates of screening for tobacco use in the population with SMI, no studies measuring this outcome that met our inclusion criteria were identified.Figure 1

Bottom Line: For example, rates of lipid testing for antipsychotic users ranged from 6% to 85%.For some conditions, rates of screening were consistently high.For example, screening rates for hypertension ranged from 79% - 88%.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health, 624 N Broadway St., Room 405, Baltimore, MD, 21205, USA. jballer@jhu.edu.

ABSTRACT

Background: Adults with serious mental illness have a mortality rate two to three times higher than the overall US population, much of which is due to somatic conditions, especially cardiovascular disease. Given the disproportionately high prevalence of cardiovascular risk factors in the population with SMI, screening for these conditions is an important first step for timely diagnosis and appropriate treatment. This comprehensive literature review summarizes screening rates for cardiovascular risk factors in the population with serious mental illness.

Methods: Relevant articles published between 2000 and 2013 were identified using the EMBASE, PsychInfo, PubMed, SCOPUS and Web of Science databases. We reviewed 10 studies measuring screening rates for obesity, diabetes, dyslipidemia, and hypertension in the population with serious mental illness. Two reviewers independently extracted information on screening rates, study population, and study setting.

Results: Rates of screening varied considerably by time period, study population, and data source for all medical conditions. For example, rates of lipid testing for antipsychotic users ranged from 6% to 85%. For some conditions, rates of screening were consistently high. For example, screening rates for hypertension ranged from 79% - 88%.

Conclusions: There is considerable variation in screening of cardiovascular risk factors in the population with serious mental illness, with significant need for improvement in some study populations and settings. Implementation of standard screening protocols triggered by diagnosis of serious mental illness or antipsychotic use may be promising avenues for ensuring timely diagnosis and treatment of cardiovascular risk factors in this population.

Show MeSH
Related in: MedlinePlus