Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study.
Ethnicity and cardiovascular health inequalities in people with severe mental illnesses: protocol for the E-CHASM study.
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DOI：
10.1007/s00127-016-1185-8
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发表时间：
2016-04
影响因子：
4.4
通讯作者：
Prince MJ
中科院分区：
文献类型：
--
作者：
Das-Munshi J;Ashworth M;Gaughran F;Hull S;Morgan C;Nazroo J;Roberts A;Rose D;Schofield P;Stewart R;Thornicroft G;Prince MJ
严重精神疾病（SMI）患者的预期寿命会缩短17至20年。三分之一的死亡是由于心血管疾病。本研究将在英国少数民族（印度人、巴基斯坦人、孟加拉人、加勒比黑人、非洲黑人和爱尔兰人）中建立SMI与心血管疾病的关系。E-CHASM是一项混合方法研究，利用了125万份电子病历的数据。对常规患者记录的二次分析将确定是否存在特定原因死亡率、心血管疾病患病率和少数民族重度精神病患者获得医疗保健的差异。一个嵌套的定性研究将被用来评估障碍，获得医疗保健，无论是从服务用户和提供者的角度。在初级保健方面，993，116名年龄在18岁以上的人提供了伦敦四个内城区（地方政府区域）186/189（98%）实践的数据。根据初级保健记录，各行政区的SMI患病率范围为1.3- 1.7%。初级保健样本包括孟加拉国人[n = 94，643（10%）]、印度人[n = 6086（6%）]、巴基斯坦人[n = 35，596（4%）]、加勒比黑人[n = 45，013（5%）]、非洲黑人[n = 75，454（8%）]和爱尔兰人[n = 13，745（1%）]。在二级护理数据库中，2007-2013年期间有12，432名SMI患者提供了信息;流行诊断为精神分裂症[n = 6805（55%）]、情感性精神障碍[n = 1438（12%）]和双相情感障碍[n = 4112（33%）]。这一样本中最大的少数民族群体是加勒比黑人[1 432人（12%）]和非洲黑人（1 393人（11%））。在患有严重精神疾病的少数民族群体中，缺乏关于心血管疾病的研究。E-CHASM研究将填补这一知识空白。
People with severe mental illnesses (SMI) experience a 17- to 20-year reduction in life expectancy. One-third of deaths are due to cardiovascular disease. This study will establish the relationship of SMI with cardiovascular disease in ethnic minority groups (Indian, Pakistani, Bangladeshi, black Caribbean, black African and Irish), in the UK. E-CHASM is a mixed methods study utilising data from 1.25 million electronic patient records. Secondary analysis of routine patient records will establish if differences in cause-specific mortality, cardiovascular disease prevalence and disparities in accessing healthcare for ethnic minority people living with SMI exist. A nested qualitative study will be used to assess barriers to accessing healthcare, both from the perspectives of service users and providers. In primary care, 993,116 individuals, aged 18+, provided data from 186/189 (98 %) practices in four inner-city boroughs (local government areas) in London. Prevalence of SMI according to primary care records, ranged from 1.3–1.7 %, across boroughs. The primary care sample included Bangladeshi [n = 94,643 (10 %)], Indian [n = 6086 (6 %)], Pakistani [n = 35,596 (4 %)], black Caribbean [n = 45,013 (5 %)], black African [n = 75,454 (8 %)] and Irish people [n = 13,745 (1 %)]. In the secondary care database, 12,432 individuals with SMI over 2007–2013 contributed information; prevalent diagnoses were schizophrenia [n = 6805 (55 %)], schizoaffective disorders [n = 1438 (12 %)] and bipolar affective disorder [n = 4112 (33 %)]. Largest ethnic minority groups in this sample were black Caribbean [1432 (12 %)] and black African (1393 (11 %)). There is a dearth of research examining cardiovascular disease in minority ethnic groups with severe mental illnesses. The E-CHASM study will address this knowledge gap.