Use of Primary Care and by Middle Aged and Older Persons with Schizophrenia.

Abstract

INTRODUCTION: Comorbid medical conditions and receipt of primary medical care are important aspects of healthcare for older persons with schizophrenia. This study describes the prevalence of comorbid medical conditions and the factors associated with the use of primary care treatment in a group of middle-aged and older persons with schizophrenia. METHODS: Using baseline data from an ongoing study of functional skills training (N= 236), we determined the self-reported prevalence of 8 common medical conditions. In addition, patients who did (n= 146) versus those who did not (n= 90) receive primary care treatment were compared on demographic characteristics, psychiatric symptoms, and comorbid medical conditions using both univariate and multivariate analyses. RESULTS: The most common medical conditions were hypertension (31%), arthritis (25%), and diabetes (14%) and almost 60% of the patients had one or more medical conditions. More than 60% of the patients had received primary care treatment during the prior 3 months. Patients who used primary care were older, more likely to have received mental health treatment, and more likely to have a medical condition, especially, diabetes. There were no differences between the groups, however, in the severity of psychopathologic symptoms or cognitive deficits. Multivariate logistic regression analysis found that older age and diabetes were associated with greater utilization of primary care treatment. DISCUSSION: In middle-aged and older patients with schizophrenia, comorbid medical conditions were common and a majority of the patients did receive primary care treatment in the prior 3 months. Older patients and those with comorbid medical conditions were more likely to receive primary care, but there was no relationship between severity of psychiatric symptoms and receipt of primary care. Additional research is needed to determine sociodemographic and clinical factors associated with use of primary care utilization in groups of participants with a broader range of psychiatric symptom severity and supportive environments.