CARDIOVASCULAR AND DIABETES HEALTHCARE IN PATIENTS WITH SCHIZOPHRENIA

Abstract

Introduction Schizophrenia is a severe and persistent mental illness associated with early mortality and a higher rate of medical comorbidity compared to the general population. Individuals with schizophrenia are at risk of healthcare disparities including reduced access to primary care and suboptimal health maintenance interventions. Barriers to care can include impairment communicating with healthcare providers, the stigma of psychiatric disease, and a poor understanding of medical condition and need for treatment all of which can delay diagnosis and timely treatment. However, only few studies exist related to healthcare access at the end-of-life. Because individuals with schizophrenia die 10-20?years younger than the general population, it is important to identify modifiable risk factors to improve care in this vulnerable population. Specifically, we aimed to investigate the prevalence of cardiovascular disease and diabetes compared to controls, and evaluate occurrence of routine laboratory studies and preventive health measures. Methods We conducted a retrospective examination of healthcare access among deceased individuals with and without schizophrenia. The Mayo Clinic Advanced Cohort Explorer was used to identify records with ICD -9/10 codes (295.0 – 295.9; F20.0 –F20.9) to establish a cohort of deceased patients with schizophrenia (N = 1191) and a date of death between 1/1/1999 – 1/1/2019. A control group without schizophrenia or any mental disorder was established (N = 1191) and matched by gender and age at time of death. Using a retrospective cohort design the prevalence of cardiovascular disease and diabetes were measured in subjects ≥ 50?years of age within the 3?years preceding death; the following routine health maintenance studies were also evaluated: complete blood count (CBC), low density lipoprotein (LDL), hemoglobin A1C (HbA1c), and electrocardiography (ECG).Between group differences were determined using chi-square (Х2) with p Results The average age of death was 71.4?years in both groups due to matching by age of death. The age range among patients and controls spanned from 50 to 104?years. Individuals with schizophrenia were significantly more likely to be single, divorced, or separated (p Conclusions Our findings indicate higher rates of diabetes and cardiovascular disease in individuals with schizophrenia compared to controls ≥ 50?years of age matched by gender and age of death which is consistent with other studies. However patients with schizophrenia were less likely to have received an ECG within the three years preceding death despite the aforementioned comorbidities. The schizophrenia group was significantly more likely to have received routine HbA1c and lipid panel testing however. This research was funded by: No funding sources were used for this project