Prevention of coronary heart disease in people with severe mental illnesses: a qualitative study of patient and professionals' preferences for care

Wright, Christine A.; Osborn, David P. J.; Nazareth, Irwin; King, Michael B.
January 2006
BMC Psychiatry;2006, Vol. 6, p16
Academic Journal
Background: People with severe mental illness (SMI) are at increased risk of developing coronary heart disease (CHD) and there is growing emphasis on the need to monitor their physical health. However, there is little consensus on how services for the primary prevention of CHD should be organised for this patient group. We explored the views of people with SMI and health professionals from primary care and community mental health teams (CMHTs) on how best to provide these services. Methods: In-depth interviews were conducted with a purposive sample of patients with SMI (n = 31) and staff from primary care (n = 10) and community mental health teams (n = 25) in North Central London. Transcripts of the qualitative interviews were analysed using a 'framework' approach to identify the main themes in opinions regarding various service models. Results: Cardiovascular risk factors in people with SMI were of concern to participants. However, there was some disagreement about the best way to deliver appropriate care. Although staff felt that primary care should take responsibility for risk factor screening and management, patients favoured CHD screening in their CMHT. Problems with both approaches were identified. These included a lack of familiarity in general practice with SMI and antipsychotic side effects and poor communication of physical health issues to the CMHT. Lack of knowledge regarding CHD risk factor screening and difficulties in interpreting screening results and implementing appropriate interventions exist in secondary care. Conclusion: Management of physical health care for people with SMI requires complex solutions that cross the primary-secondary care interface. The views expressed by our participants suggest that neither primary nor secondary care services on their own can provide a comprehensive service for all patients. The increased risk of CHD associated with SMI and antipsychotic medications requires flexible solutions with clear lines of responsibility for assessing, communicating and managing CHD risks.


Related Articles

  • Mentally ill miss out on healthcare. Baines, Emma // GP: General Practitioner;9/22/2003, p13 

    Health and social services have been condemned for neglecting the physical health of people with mental illness. A briefing paper published last week by the mental health charity Mentality said people with severe mental illness were almost twice as likely to die from coronary heart disease as...

  • Adapt CHD protocol to your local needs. McCartney Dr, Peter // GP: General Practitioner;10/28/2002, p35 

    Focuses on the importance of using coronary heart disease (CHD) protocols in general practices. Benefits provided by CHD protocol; Necessity for CHD protocol to get approval from local Primary Care Trusts; Importance of CHD register review; Details of CHD register review.

  • Provide CHD care with a computer.  // GP: General Practitioner;5/13/2002, p55 

    Discusses the efficiency of an information technology-based (IT) system to provide medical care for Coronary Heart Diseases (CHD). Advantages provided by the IT-based program to patients; Procedure of CHD risk assessment of the program; Cost of the IT-based program; Web site providing details...

  • Government applauds GP success on CHD NSF. Polak, Monika // GP: General Practitioner;3/10/2003, p7 

    Reports on the success of the National Service Framework (NSF) in Great Britain in improving medical services for coronary heart disease (CHD). Increase in prescribing levels of CHD; Reaction of General Practitioners Committee chairman Peter Fellows regarding the success of NSF.

  • Mental health quality pointers. Young, Venetia // GP: General Practitioner;11/3/2006, p54 

    The article presents the author's comments on how to maintain the patient mental health register. According to him, point accumulation in the mental health domain is one of the biggest challenges in the quality framework. The ground for the register is that the patients with severe mental...

  • Association between physical and mental health-related quality of life and adverse outcomes; a retrospective cohort study of 5,272 Scottish adults. Ul-Haq, Zia; Mackay, Daniel F.; Pell, Jill P. // BMC Public Health;2014, Vol. 14 Issue 1, p1 

    Background Health-related quality of life (HRQoL) is associated with adverse outcomes in disease- specific populations. This study examines whether it is also independent predictor of incident cancer, coronary heart disease (CHD) and mortality in the general population. Methods The records of...

  • Major Depressive Disorder and Coronary Artery Disease: A Synergistic Biopsychosocial Phenomenon? Kudlow, Paul A.; Chavlovski, Anna // University of Toronto Medical Journal;May2012, Vol. 89 Issue 3, p151 

    Affecting an estimated 5-10% of the population at any given time, major depressive disorder (MDD) and coronary artery disease (CAD) are common and debilitating illnesses. Although traditionally viewed as separate disorders, it has been estimated that up to 20% of patients diagnosed with CAD also...

  • Psychiatry in Medicine.  // Current Medical Literature: Psychiatry;2006, Vol. 17 Issue 3, p94 

    The article presents abstracts of psychiatric research. They include "Obesity among individuals with serious mental illness," "Risk for coronary heart disease in people with severe mental illness: cross-sectional comparative study in primary care," and "Adverse events during medical and surgical...

  • THE HIGH RATE OF PSYCHIATRIC DISORDERS IN ELDERLY CARDIAC PATIENTS. Schuckit, Marc A. // Angiology;Apr1977, Vol. 28 Issue 4, p235 

    Evaluates the relationship between physical and mental disorders in a group of elderly medical and surgical patients, controlling for underlying medical diagnosis. Focus on subjects with cardiac abnormalities; Rate of psychiatric disorders in elderly cardiac patients; Incidence of depression,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics