Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study
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...
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| Format: | Article |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/10/e038013.full |
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| author | Michelle Greiver Sumeet Kalia Babak Aliarzadeh Rahim Moineddin Frank Sullivan Braden O’Neill Martina Kelly |
| author_facet | Michelle Greiver Sumeet Kalia Babak Aliarzadeh Rahim Moineddin Frank Sullivan Braden O’Neill Martina Kelly |
| author_sort | Michelle Greiver |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-3b5d0c8c46d94dca90d7323fd46b1617 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-3b5d0c8c46d94dca90d7323fd46b16172024-11-16T09:00:08ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2020-038013Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort studyMichelle Greiver0Sumeet Kalia1Babak Aliarzadeh2Rahim Moineddin3Frank Sullivan4Braden O’Neill5Martina Kelly6University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, CanadaUniversity of Toronto Temerty Faculty of Medicine, Toronto, Ontario, CanadaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canadadirector of University of Toronto Practice-Based Research Network (UTOPIAN), Gordon F Cheesbrough chair in family and community medicineFamily and Community Medicine, University of Toronto, Toronto, Ontario, CanadaDepartment of Family Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, CanadaObjectives 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.https://bmjopen.bmj.com/content/10/10/e038013.full |
| spellingShingle | Michelle Greiver Sumeet Kalia Babak Aliarzadeh Rahim Moineddin Frank Sullivan Braden O’Neill Martina Kelly Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study BMJ Open |
| title | Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study |
| title_full | Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study |
| title_fullStr | Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study |
| title_full_unstemmed | Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study |
| title_short | Cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in Ontario, Canada: retrospective cohort study |
| title_sort | cardiovascular risk factor documentation and management in primary care electronic medical records among people with schizophrenia in ontario canada retrospective cohort study |
| url | https://bmjopen.bmj.com/content/10/10/e038013.full |
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