Disparities in Screening and Treatment of Cardiovascular Diseases in Patients With Mental Disorders Across the World: Systematic Review and Meta-Analysis of 47 Observational Studies

Solmi, Marco and Fiedorowicz, Jess and Poddighe, Laura and Delogu, Marco and Miola, Alessandro and Hoye, Anne and Heiberg, Ina and Stubbs, Brendon and Smith, Lee and Larsson, Henrik and Attar, Rubina and Nielsen, Rene and Cortese, Samuele and Shin, Jae Il and Fusar-Poli, Paolo and Firth, Joseph and Yatham, Lakshmi and Carvalho, Andre F. and Castle, David and Seeman, Mary and Correll, Christoph (2021) Disparities in Screening and Treatment of Cardiovascular Diseases in Patients With Mental Disorders Across the World: Systematic Review and Meta-Analysis of 47 Observational Studies. American Journal of Psychiatry. ISSN 1535-7228

Full text not available from this repository.
Official URL: https://doi.org/10.1176/appi.ajp.2021.21010031

Abstract

Objective: This study used meta-analysis to assess disparities in cardiovascular disease (CVD) screening and treatment in people with mental disorders, a group that has elevated CVD incidence and mortality. Methods: The authors searched PubMed and PsycInfo through July 31, 2020, and conducted a random-effect meta-analysis of observational studies comparing CVD screening and treatment in people with and without mental disorders. The primary outcome was odds ratios for CVD screening and treatment. Sensitivity analyses on screening and treatment separately and on specific procedures, subgroup analyses by country, and by controlling for confounding by indication, as well as meta-regressions, were also run, and publication bias and quality were assessed. Results: Forty-seven studies (N=24,400,452 patients, of whom 1,283,602 had mental disorders) from North America (k=26), Europe (k=16), Asia (k=4), and Australia (k=1) were meta-analyzed. Lower rates of screening or treatment in patients with mental disorders emerged for any CVD (k=47, odds ratio=0.773, 95% CI=0.742, 0.804), coronary artery disease (k=34, odds ratio=0.734, 95% CI=0.690, 0.781), cerebrovascular disease (k=8, odds ratio=0.810, 95% CI=0.779, 0.842), and other mixed CVDs (k=11, odds ratio=0.839, 95% CI=0.761, 0.924). Significant disparities emerged for any screening, any intervention, catheterization or revascularization in coronary artery disease, intravenous thrombolysis for stroke, and treatment with any and with specific medications for CVD across all mental disorders (except for CVD medications in mood disorders). Disparities were largest for schizophrenia, and they differed across countries. Median study quality was high (Newcastle-Ottawa Scale score, 8); higher-quality studies found larger disparities, and publication bias did not affect results. Conclusions: People with mental disorders, and those with schizophrenia in particular, receive less screening and lower-quality treatment for CVD. It is of paramount importance to address underprescribing of CVD medications and underutilization of diagnostic and therapeutic procedures across all mental disorders.

Item Type: Journal Article
Keywords: Screening, Cardiovascular Disease, Mental Disorders, Mental Health Care/Service Delivery Systems, Schizophrenia Spectrum and Other Psychotic Disorders, Bipolar and Related Disorders, Physical Health
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 07 Jun 2021 09:17
Last Modified: 26 Nov 2021 14:08
URI: https://arro.anglia.ac.uk/id/eprint/706638

Actions (login required)

Edit Item Edit Item