Projects per year
Abstract
BACKGROUND: People with serious mental illness (SMI) experience higher mortality partially attributable to higher long-term condition (LTC) prevalence. However, little is known about multiple LTCs (MLTCs) clustering in this population.
METHODS: People from South London with SMI and two or more existing LTCs aged 18+ at diagnosis were included using linked primary and mental healthcare records, 2012-2020. Latent class analysis (LCA) determined MLTC classes and multinominal logistic regression examined associations between demographic/clinical characteristics and latent class membership.
RESULTS: The sample included 1924 patients (mean (s.d.) age 48.2 (17.3) years). Five latent classes were identified: 'substance related' (24.9%), 'atopic' (24.2%), 'pure affective' (30.4%), 'cardiovascular' (14.1%), and 'complex multimorbidity' (6.4%). Patients had on average 7-9 LTCs in each cluster. Males were at increased odds of MLTCs in all four clusters, compared to the 'pure affective'. Compared to the largest cluster ('pure affective'), the 'substance related' and the 'atopic' clusters were younger [odds ratios (OR) per year increase 0.99 (95% CI 0.98-1.00) and 0.96 (0.95-0.97) respectively], and the 'cardiovascular' and 'complex multimorbidity' clusters were older (ORs 1.09 (1.07-1.10) and 1.16 (1.14-1.18) respectively). The 'substance related' cluster was more likely to be White, the 'cardiovascular' cluster more likely to be Black (compared to White; OR 1.75, 95% CI 1.10-2.79), and both more likely to have schizophrenia, compared to other clusters.
CONCLUSION: The current study identified five latent class MLTC clusters among patients with SMI. An integrated care model for treating MLTCs in this population is recommended to improve multimorbidity care.
| Original language | English |
|---|---|
| Number of pages | 12 |
| Journal | Psychological Medicine |
| Early online date | 29 Apr 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 29 Apr 2022 |
Bibliographical note
© The Author(s), 2022Projects
- 1 Finished
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Multimorbidity Among People with Serious mental illness (MAPS): Mapping disease clusters, risk factors, trajectories, service barriers and outcomes
Jacobs, R. (Principal investigator), Churchill, R. (Co-investigator), Coventry, P. (Co-investigator), Doran, T. (Co-investigator), Gilbody, S. (Co-investigator), Knowles, S. E. (Co-investigator), Peckham, E. J. (Co-investigator), Pleace, N. (Co-investigator), Prady, S. L. (Co-investigator), Rice, N. (Co-investigator), Siddiqi, N. (Co-investigator), Taylor, J. (Co-investigator), White, P. C. L. (Co-investigator) & de Oliveira, C. (Co-investigator)
MEDICAL RESEARCH COUNCIL (MRC)
1/07/20 → 28/02/21
Project: Research project (funded) › Research