Nationwide Evaluation of Quality of Care Indicators for Individuals with Severe Mental Illness and Diabetes Mellitus, Following Israel's Mental Health Reform

Overview

Journal Community Ment Health J

Specialty Health Services

Date 2023 Sep 11

PMID 37697183

Authors

Deborah Barasche-Berdah

Eliana Ein-Mor

Ronit Calderon-Margalit

Adam J Rose

Michal Krieger

Shuli Brammli-Greenberg

Arye Ben-Yehuda

Orly Manor

Arnon D Cohen

Edna Bar-Ratson

Ronen Bareket

Eran Matz

Ora Paltiel

Affiliations

Soon will be listed here.

Abstract

Diabetes Mellitus (DM) is more common among individuals with severe mental illness (SMI). We aimed to assess quality-of-care-indicators in individuals with SMI following the 2015 Israel's Mental-Health-reform. We analyzed yearly changes in 2015-2019 of quality-of-care-measures and intermediate-DM-outcomes, with adjustment for gender, age-group, and socioeconomic status (SES) and compared individuals with SMI to the general adult population. Adults with SMI had higher prevalences of DM (odds ratio (OR) = 1.64; 95% confidence intervals (CI): 1.61-1.67) and obesity (OR = 2.11; 95% CI: 2.08-2.13), compared to the general population. DM prevalence, DM control, and obesity rates increased over the years in this population. In 2019, HbA1c testing was marginally lower (OR = 0.88; 95% CI: 0.83-0.94) and uncontrolled DM (HbA1c > 9%) slightly more common among patients with SMI (OR = 1.22; 95% CI: 1.14-1.30), control worsened by decreasing SES. After adjustment, uncontrolled DM (adj. OR = 1.02; 95% CI: 0.96-1.09) was not associated with SMI. Cardio-metabolic morbidity among patients with SMI may be related to high prevalences of obesity and DM rather than poor DM control. Effective screening for metabolic diseases in this population and social reforms are required.

References

Afzal M, Siddiqi N, Ahmad B, Afsheen N, Aslam F, Ali A . Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne). 2021; 12:769309. PMC: 8656226. DOI: 10.3389/fendo.2021.769309. View

Barnett A, Mackin P, Chaudhry I, Farooqi A, Gadsby R, Heald A . Minimising metabolic and cardiovascular risk in schizophrenia: diabetes, obesity and dyslipidaemia. J Psychopharmacol. 2007; 21(4):357-73. DOI: 10.1177/0269881107075509. View

Brink M, Green A, Bojesen A, Lamberti J, Conwell Y, Andersen K . Excess medical comorbidity and mortality across the lifespan in schizophrenia.: A nationwide Danish register study. Schizophr Res. 2018; 206:347-354. DOI: 10.1016/j.schres.2018.10.020. View

Butterworth P . The prevalence of mental disorders among income support recipients: an important issue for welfare reform. Aust N Z J Public Health. 2004; 27(4):441-8. DOI: 10.1111/j.1467-842x.2003.tb00424.x. View

Castillo-Sanchez M, Fabregas-Escurriola M, Berge-Baquero D, Fernandez-SanMartin M, Goday-Arno A . Screening of cardiovascular risk factors in patients with schizophrenia and patients treated with antipsychotic drugs: are we equally exhaustive as with the general population?. Clin Exp Hypertens. 2017; 39(5):441-447. DOI: 10.1080/10641963.2016.1267200. View

Chesney E, Goodwin G, Fazel S . Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014; 13(2):153-60. PMC: 4102288. DOI: 10.1002/wps.20128. View

De Hert M, Dekker J, Wood D, Kahl K, Holt R, Moller H . Cardiovascular disease and diabetes in people with severe mental illness position statement from the European Psychiatric Association (EPA), supported by the European Association for the Study of Diabetes (EASD) and the European Society of.... Eur Psychiatry. 2009; 24(6):412-24. DOI: 10.1016/j.eurpsy.2009.01.005. View

Desai M, Rosenheck R, Druss B, Perlin J . Mental disorders and quality of diabetes care in the veterans health administration. Am J Psychiatry. 2002; 159(9):1584-90. DOI: 10.1176/appi.ajp.159.9.1584. View

Dickerson F, Origoni A, Schroeder J, Schweinfurth L, Stallings C, Savage C . Mortality in schizophrenia and bipolar disorder: Clinical and serological predictors. Schizophr Res. 2015; 170(1):177-83. DOI: 10.1016/j.schres.2015.11.010. View

10.

Dixon L, Kreyenbuhl J, Dickerson F, Donner T, Brown C, Wohlheiter K . A comparison of type 2 diabetes outcomes among persons with and without severe mental illnesses. Psychiatr Serv. 2004; 55(8):892-900. DOI: 10.1176/appi.ps.55.8.892. View

11.

Fernandez Guijarro S, Miguel Garcia C, Pomarol-Clotet E, Egea Lopez E, Burjales Marti M, Cuadra M . Metabolic Syndrome Screening in People With Severe Mental Illness: Results From Two Spanish Community Mental Health Centers. J Am Psychiatr Nurses Assoc. 2019; 26(2):162-171. DOI: 10.1177/1078390319826686. View

12.

Frayne S, Halanych J, Miller D, Wang F, Lin H, Pogach L . Disparities in diabetes care: impact of mental illness. Arch Intern Med. 2005; 165(22):2631-8. DOI: 10.1001/archinte.165.22.2631. View

13.

Goldberg R, Kreyenbuhl J, Medoff D, Dickerson F, Wohlheiter K, Fang L . Quality of diabetes care among adults with serious mental illness. Psychiatr Serv. 2007; 58(4):536-43. DOI: 10.1176/ps.2007.58.4.536. View

14.

Jafari S, Fernandez-Enright F, Huang X . Structural contributions of antipsychotic drugs to their therapeutic profiles and metabolic side effects. J Neurochem. 2011; 120(3):371-84. DOI: 10.1111/j.1471-4159.2011.07590.x. View

15.

Jaffe D, Shmueli A, Ben-Yehuda A, Paltiel O, Calderon R, Cohen A . Community healthcare in Israel: quality indicators 2007-2009. Isr J Health Policy Res. 2012; 1(1):3. PMC: 3415131. DOI: 10.1186/2045-4015-1-3. View

16.

Smith D, Forty L, Russell E, Caesar S, Walters J, Cooper C . Sub-threshold manic symptoms in recurrent major depressive disorder are a marker for poor outcome. Acta Psychiatr Scand. 2009; 119(4):325-9. DOI: 10.1111/j.1600-0447.2008.01324.x. View

17.

Jorgensen M, Mainz J, Carinci F, Thomsen R, Johnsen S . Quality and Predictors of Diabetes Care Among Patients With Schizophrenia: A Danish Nationwide Study. Psychiatr Serv. 2017; 69(2):179-185. DOI: 10.1176/appi.ps.201600460. View

18.

Kodesh A, Goldshtein I, Gelkopf M, Goren I, Chodick G, Shalev V . Epidemiology and comorbidity of severe mental illnesses in the community: findings from a computerized mental health registry in a large Israeli health organization. Soc Psychiatry Psychiatr Epidemiol. 2012; 47(11):1775-82. DOI: 10.1007/s00127-012-0478-9. View

19.

Kovess V, Gysens S, Poinsard R, Chanoit P, Labarte S . Mental health and use of care in people receiving a French social benefit. Soc Psychiatry Psychiatr Epidemiol. 2000; 34(11):588-94. DOI: 10.1007/s001270050179. View

20.

Krein S, Bingham C, McCarthy J, Mitchinson A, Payes J, Valenstein M . Diabetes treatment among VA patients with comorbid serious mental illness. Psychiatr Serv. 2006; 57(7):1016-21. DOI: 10.1176/ps.2006.57.7.1016. View