Abstract
BackgroundGeneral practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is therefore considered appropriate for preventing, diagnosing and managing most mental health problems.AimsThis study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice.MethodsA cross-sectional design was used. A finder tool embedded in the practice software assisted general practitioners (GPs) coding adult patients with SMDs. Eleven practices uploaded anonymous data on 2,203 patients. Variables analysed included disease code, consultations, prescriptions, sex, patient status and age.ResultsOverall, 2.9% (n = 2,337) of patients had ever been coded with a SMD, 2.4% (n = 1,964) coded with depressive disorder ever and 0.26% (n = 209) and 0.3% (n = 233) with bipolar disorder and schizophrenia, respectively. Overall, 68.0% (n = 1,336) of patients with depressive disorder were female, and 74.0% (n = 171) of patients with schizophrenia were public patients. The median consultation rate in the previous 3 years was highest for schizophrenia patients at 24.5 visits.ConclusionsCoding of SMDs in Irish general practice appears incomplete. Patients with SMDs have high consultation rates. Patients with depressive disorder are more likely to be female and public patients. This research suggests that the improvement of coding in Irish general practice is the first practical step required to detecting prevalence rates.
Highlights
General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients
Descriptive statistics are provided on patient status; there are three types of patient status: ‘private patients’, ‘public patients’ and ‘doctor visit card patients’
This study has revealed that electronic tools to assist general practitioners (GPs) in finding people with mental health diagnoses in GP software systems can greatly increase coding of severe mental disorders (SMDs); this was the case for schizophrenia and bipolar disorder where 11% and 28% respectively of those coded were coded after the finder tool was used
Summary
General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is considered appropriate for preventing, diagnosing and managing most mental health problems. Aims This study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice. General practitioners (GPs) constitute the largest group of healthcare professionals in primary care in Ireland. GPs are the gatekeepers of Irish healthcare and they offer continuity of care to patients. It is thought that Irish primary care could be ‘ideally situated’ for preventing, diagnosing and managing most mental health problems [5]. In one survey [6], Irish GPs estimated that 95% of patients with mental health issues received their care in primary care. Mental health policy in Ireland [7, 8] considers primary care as pivotal in the care of patients with mental illness
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