Diabetes care among individuals with and without schizophrenia in three Canadian provinces: a retrospective cohort study

Braden O'Neill; Abban Yusuf; Paul Kurdyak; Tara Kiran; Frank Sullivan; Tao Chen; Sumeet Kalia; David Eisen; Elizabeth Anderson; Peter Selby; David Campbell

doi:10.1016/j.genhosppsych.2023.02.007

Diabetes care among individuals with and without schizophrenia in three Canadian provinces: a retrospective cohort study

Braden O'Neill^*, Abban Yusuf, Paul Kurdyak, Tara Kiran, Frank Sullivan, Tao Chen, Sumeet Kalia, David Eisen, Elizabeth Anderson, Peter Selby, David Campbell

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

OBJECTIVE

Diabetes is present in approximately 10% of people living with schizophrenia and substantially contributes to early mortality, but some aspects of diabetes care among those with schizophrenia have been inadequately investigated to date. We assessed diabetes care and comorbidity management among people with and without schizophrenia.

METHODS

We conducted a cohort study with data obtained from primary care electronic medical records stored in the Diabetes Action Canada (DAC) National Repository from Alberta, Ontario, and Quebec, Canada. The population studied included patients with diabetes, with and without schizophrenia, who had at least 3 primary care visits in a 2 year period between July 2017 and June 2019. Outcomes included glycemia; diabetes complication screening and monitoring; antihyperglycemic and cardioprotective medication prescription; health service use.

RESULTS

We identified 69,512 patients with diabetes; 911 (1.3%) of whom also had schizophrenia. Prevalence of high HbA1C (>8.5%) (9083/68601; 13.2% vs. 137/911; 15.0%) and high blood pressure (>130/80 mmHg) (4248/68601; 6.2% vs. 73/911; 8.0%) was similar between the two groups. Half (50.0%) of patients with schizophrenia (n = 455) had 11 or more primary care visits in the past year, compared with 27.8% of people without schizophrenia. (p < 0.0001). Patients with schizophrenia had lower odds of ever having blood pressure recorded (OR = 0.81, 95% CI 0.71-0.94) and fewer of those with chronic kidney disease (CKD) were prescribed renin-angiotensin aldosterone system inhibitors, compared to patients without schizophrenia (10.3% vs 15.8%, p = 0.0005).

CONCLUSIONS

Patients with diabetes and schizophrenia achieved similar blood glucose and blood pressure levels to those without schizophrenia, and had more primary care visits. However, they had fewer blood pressure readings and lower prescription of recommended medications among those who also had CKD. These results are both encouraging and represent opportunities for improvement in care.

Original language	English
Pages (from-to)	19-25
Number of pages	7
Journal	General hospital psychiatry
Volume	82
Early online date	8 Mar 2023
DOIs	https://doi.org/10.1016/j.genhosppsych.2023.02.007
Publication status	Published - 8 May 2023

Keywords

Diabetes
Schizophrenia
Quality of care
Smoking cessation
Kidney disease
Hypertension

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.genhosppsych.2023.02.007

Cite this

@article{000a9696e55f474f8817836e2ea3c9b7,

title = "Diabetes care among individuals with and without schizophrenia in three Canadian provinces: a retrospective cohort study",

abstract = "OBJECTIVEDiabetes is present in approximately 10% of people living with schizophrenia and substantially contributes to early mortality, but some aspects of diabetes care among those with schizophrenia have been inadequately investigated to date. We assessed diabetes care and comorbidity management among people with and without schizophrenia.METHODSWe conducted a cohort study with data obtained from primary care electronic medical records stored in the Diabetes Action Canada (DAC) National Repository from Alberta, Ontario, and Quebec, Canada. The population studied included patients with diabetes, with and without schizophrenia, who had at least 3 primary care visits in a 2 year period between July 2017 and June 2019. Outcomes included glycemia; diabetes complication screening and monitoring; antihyperglycemic and cardioprotective medication prescription; health service use.RESULTS We identified 69,512 patients with diabetes; 911 (1.3%) of whom also had schizophrenia. Prevalence of high HbA1C (>8.5%) (9083/68601; 13.2% vs. 137/911; 15.0%) and high blood pressure (>130/80 mmHg) (4248/68601; 6.2% vs. 73/911; 8.0%) was similar between the two groups. Half (50.0%) of patients with schizophrenia (n = 455) had 11 or more primary care visits in the past year, compared with 27.8% of people without schizophrenia. (p < 0.0001). Patients with schizophrenia had lower odds of ever having blood pressure recorded (OR = 0.81, 95% CI 0.71-0.94) and fewer of those with chronic kidney disease (CKD) were prescribed renin-angiotensin aldosterone system inhibitors, compared to patients without schizophrenia (10.3% vs 15.8%, p = 0.0005).CONCLUSIONS Patients with diabetes and schizophrenia achieved similar blood glucose and blood pressure levels to those without schizophrenia, and had more primary care visits. However, they had fewer blood pressure readings and lower prescription of recommended medications among those who also had CKD. These results are both encouraging and represent opportunities for improvement in care.",

keywords = "Diabetes, Schizophrenia, Quality of care, Smoking cessation, Kidney disease, Hypertension",

author = "Braden O'Neill and Abban Yusuf and Paul Kurdyak and Tara Kiran and Frank Sullivan and Tao Chen and Sumeet Kalia and David Eisen and Elizabeth Anderson and Peter Selby and David Campbell",

note = "Funding: This study was funded by the Diabetes Action Canada National Data Repository. ",

year = "2023",

month = may,

day = "8",

doi = "10.1016/j.genhosppsych.2023.02.007",

language = "English",

volume = "82",

pages = "19--25",

journal = "General hospital psychiatry",

issn = "0163-8343",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Diabetes care among individuals with and without schizophrenia in three Canadian provinces

T2 - a retrospective cohort study

AU - O'Neill, Braden

AU - Yusuf, Abban

AU - Kurdyak, Paul

AU - Kiran, Tara

AU - Sullivan, Frank

AU - Chen, Tao

AU - Kalia, Sumeet

AU - Eisen, David

AU - Anderson, Elizabeth

AU - Selby, Peter

AU - Campbell, David

N1 - Funding: This study was funded by the Diabetes Action Canada National Data Repository.

PY - 2023/5/8

Y1 - 2023/5/8

N2 - OBJECTIVEDiabetes is present in approximately 10% of people living with schizophrenia and substantially contributes to early mortality, but some aspects of diabetes care among those with schizophrenia have been inadequately investigated to date. We assessed diabetes care and comorbidity management among people with and without schizophrenia.METHODSWe conducted a cohort study with data obtained from primary care electronic medical records stored in the Diabetes Action Canada (DAC) National Repository from Alberta, Ontario, and Quebec, Canada. The population studied included patients with diabetes, with and without schizophrenia, who had at least 3 primary care visits in a 2 year period between July 2017 and June 2019. Outcomes included glycemia; diabetes complication screening and monitoring; antihyperglycemic and cardioprotective medication prescription; health service use.RESULTS We identified 69,512 patients with diabetes; 911 (1.3%) of whom also had schizophrenia. Prevalence of high HbA1C (>8.5%) (9083/68601; 13.2% vs. 137/911; 15.0%) and high blood pressure (>130/80 mmHg) (4248/68601; 6.2% vs. 73/911; 8.0%) was similar between the two groups. Half (50.0%) of patients with schizophrenia (n = 455) had 11 or more primary care visits in the past year, compared with 27.8% of people without schizophrenia. (p < 0.0001). Patients with schizophrenia had lower odds of ever having blood pressure recorded (OR = 0.81, 95% CI 0.71-0.94) and fewer of those with chronic kidney disease (CKD) were prescribed renin-angiotensin aldosterone system inhibitors, compared to patients without schizophrenia (10.3% vs 15.8%, p = 0.0005).CONCLUSIONS Patients with diabetes and schizophrenia achieved similar blood glucose and blood pressure levels to those without schizophrenia, and had more primary care visits. However, they had fewer blood pressure readings and lower prescription of recommended medications among those who also had CKD. These results are both encouraging and represent opportunities for improvement in care.

AB - OBJECTIVEDiabetes is present in approximately 10% of people living with schizophrenia and substantially contributes to early mortality, but some aspects of diabetes care among those with schizophrenia have been inadequately investigated to date. We assessed diabetes care and comorbidity management among people with and without schizophrenia.METHODSWe conducted a cohort study with data obtained from primary care electronic medical records stored in the Diabetes Action Canada (DAC) National Repository from Alberta, Ontario, and Quebec, Canada. The population studied included patients with diabetes, with and without schizophrenia, who had at least 3 primary care visits in a 2 year period between July 2017 and June 2019. Outcomes included glycemia; diabetes complication screening and monitoring; antihyperglycemic and cardioprotective medication prescription; health service use.RESULTS We identified 69,512 patients with diabetes; 911 (1.3%) of whom also had schizophrenia. Prevalence of high HbA1C (>8.5%) (9083/68601; 13.2% vs. 137/911; 15.0%) and high blood pressure (>130/80 mmHg) (4248/68601; 6.2% vs. 73/911; 8.0%) was similar between the two groups. Half (50.0%) of patients with schizophrenia (n = 455) had 11 or more primary care visits in the past year, compared with 27.8% of people without schizophrenia. (p < 0.0001). Patients with schizophrenia had lower odds of ever having blood pressure recorded (OR = 0.81, 95% CI 0.71-0.94) and fewer of those with chronic kidney disease (CKD) were prescribed renin-angiotensin aldosterone system inhibitors, compared to patients without schizophrenia (10.3% vs 15.8%, p = 0.0005).CONCLUSIONS Patients with diabetes and schizophrenia achieved similar blood glucose and blood pressure levels to those without schizophrenia, and had more primary care visits. However, they had fewer blood pressure readings and lower prescription of recommended medications among those who also had CKD. These results are both encouraging and represent opportunities for improvement in care.

KW - Diabetes

KW - Schizophrenia

KW - Quality of care

KW - Smoking cessation

KW - Kidney disease

KW - Hypertension

U2 - 10.1016/j.genhosppsych.2023.02.007

DO - 10.1016/j.genhosppsych.2023.02.007

M3 - Article

C2 - 36898192

SN - 0163-8343

VL - 82

SP - 19

EP - 25

JO - General hospital psychiatry

JF - General hospital psychiatry

ER -

Diabetes care among individuals with and without schizophrenia in three Canadian provinces: a retrospective cohort study

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this