Longitudinal perspectives on physical and mental health comorbidities among women in recovery: Implications for recovery support services and integrated care

ObjectivesTo compare the patterns of 18 physical and mental health comorbidities between people with recently diagnosed type 2 diabetes (T2D) and people without diabetes and how these change by age, gender and deprivation over time between 2004 and 2014. Also, to develop a metric to identify most prevalent comorbidities in people with T2D.DesignPopulation-based cohort study.SettingPrimary and secondary care, England, UK.Participants108 588 people with T2D and 528 667 comparators registered in 391 English general practices. Each patient with T2D aged ≥16 years between January 2004 and December 2014 registered in Clinical Practice Research Datalink GOLD practices was matched to up to five comparators without diabetes on age, gender and general practice.Primary and secondary outcome measuresPrevalence of 18 physical and mental health comorbidities in people with T2D and comparators categorised by age, gender and deprivation. Odds for association between T2D diagnosis and comorbidities versus comparators. A metric for comorbidities with prevalence of ≥5% and/or odds ≥2 in patients with T2D.ResultsOverall, 77% of patients with T2D had ≥1 comorbidity and all comorbidities were more prevalent in patients with T2D than in comparators. Across both groups, prevalence rates were higher in older people, women and those most socially deprived. Conditional logistic regression models fitted to estimate (OR, 95% CI) for association between T2D diagnosis and comorbidities showed that T2D diagnosis was significantly associated with higher odds for all conditions including myocardial infarction (OR 2.13, 95% CI 1.85 to 2.46); heart failure (OR 2.12, 1.84 to 2.43); depression (OR 1.75, 1.62 to 1.89), but non-significant for cancer (OR 1.12, 0.98 to 1.28). In addition to cardiovascular disease, the metric identified osteoarthritis, hypothyroidism, anxiety, schizophrenia and respiratory conditions as highly prevalent comorbidities in people with T2D.ConclusionsT2D diagnosis is associated with higher likelihood of experiencing other physical and mental illnesses. People with T2D are twice as likely to have cardiovascular disease as the general population. The findings highlight highly prevalent and under-reported comorbidities in people with T2D. These findings can inform future research and clinical guidelines and can have important implications on healthcare resource allocation and highlight the need for more holistic clinical care for people with recently diagnosed T2D.

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Integrating Physical and Mental Health Care in the Veterans Health Administration

10.1093/med/9780190276201.003.0007 ◽

2017 ◽

Author(s):

Lisa V. Rubenstein

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Integrated Care ◽

Veterans Health Administration ◽

Veterans Health ◽

Health Administration ◽

Physical And Mental Health ◽

Physical Health Care ◽

Mental And Physical Health

The Veterans Health Administration, part of the U.S. Department of Veterans Affairs (VA), is responsible for the largest integrated health care system in the United States and is committed historically and by statute to provide mental and physical health care for veterans. The evolution of integrated mental and physical health care in the VA serves as an in-depth, real-world example of large-scale implementation of integrated care models. The VA’s ongoing national primary care/mental health care integration initiative is the foundation for the system’s efforts in this regard. The challenges and opportunities VA implementers faced in promoting integrated mental health care show the feasibility and importance of providing integrated care and the fundamental changes required for achievement. This chapter discusses the drivers and resources, as well as the barriers, involved in the development of an integrated physical and mental health care model.

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Chronic obstructive pulmonary disease and comorbidities: a large cross-sectional study in primary care

British Journal of General Practice ◽

10.3399/bjgp17x690605 ◽

2017 ◽

Vol 67 (658) ◽

pp. e321-e328 ◽

Cited By ~ 16

Author(s):

Ula Chetty ◽

Gary McLean ◽

Deborah Morrison ◽

Karolina Agur ◽

Bruce Guthrie ◽

...

Keyword(s):

Mental Health ◽

Chronic Obstructive Pulmonary Disease ◽

Primary Care ◽

Pulmonary Disease ◽

Integrated Approach ◽

Chronic Obstructive ◽

Physical And Mental Health ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

Health Comorbidities

BackgroundChronic obstructive pulmonary disease (COPD) is common, and a major cause of morbidity and mortality worldwide. Recent studies suggest that comorbidities of COPD increase the risk of hospitalisation, polypharmacy, and mortality, but their estimated prevalence varies widely in the literature.AimTo evaluate the prevalence of 38 physical and mental health comorbidities in people with COPD, and compare findings with those for people without COPD in a large nationally representative dataset.Design and settingA cross-sectional data analysis on 1 272 685 adults in Scotland from 314 primary care practices.MethodData on COPD, along with 31 physical and seven mental health comorbidities, were extracted. The prevalence of comorbidities was compared between people who did, and did not, have COPD, standardised by age, sex, and socioeconomic deprivation.ResultsFrom the total sample, 51 928 patients had COPD (4.1%). Of these, 86.0% had at least one comorbidity, compared with 48.9% of people without COPD. Of those with COPD, 22.3% had ≥5 comorbid conditions compared with 4.9% of those who did not have COPD (adjusted odds ratio 2.63, 95% confidence interval = 2.56 to 2.70). In total, 29 of the 31 physical conditions and six of the seven mental health conditions were statistically significantly more prevalent in people who had COPD than those who did not.ConclusionPatients with COPD have extensive associated comorbidities. There is a real need for guidelines and health care to reflect this complexity, including how to detect those common comorbidities that relate to both physical and mental health, and how best to manage them. Primary care, which is unique in terms of offering expert generalist care, is best placed to provide this integrated approach.

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Physical and mental health comorbidities of epilepsy: Population-based cross-sectional analysis of 1.5 million people in Scotland

Seizure ◽

10.1016/j.seizure.2016.11.013 ◽

2017 ◽

Vol 45 ◽

pp. 125-131 ◽

Cited By ~ 20

Author(s):

Christopher J. Weatherburn ◽

Craig A. Heath ◽

Stewart W. Mercer ◽

Bruce Guthrie

Keyword(s):

Mental Health ◽

Population Based ◽

Physical And Mental Health ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Sectional Analysis ◽

Health Comorbidities

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Comparing Learning Outcomes for Mental Health Simulation Training Delivered to Entire Clinical Teams Versus Professionals Not Working Together Clinically

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.188 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S301-S301

Author(s):

L. Valdearenas ◽

C. Attoe ◽

S. Cross

Keyword(s):

Mental Health ◽

Human Factors ◽

Physical Health ◽

Learning Outcomes ◽

Simulation Training ◽

Course Evaluation ◽

Physical And Mental Health ◽

Health Simulation ◽

Mental And Physical Health ◽

Health Comorbidities

IntroductionWorking effectively with colleagues using a multidisciplinary and interprofessional approach is vital in healthcare, particularly mental health, where the interface between physical and mental health is often missed due to involvement with different specialties. Collaborative clinical practice is essential to provide the best clinical care to people experiencing mental and physical health comorbidities. Simulation training encourages experiential learning for human factors (or non-technical) skills, such as teamwork and interprofessional collaboration. This study explored the differences in learning outcomes between team and non-team training for physical and mental health comorbidities.Aims and objectivesThis project aimed to establish differences in human factors learning, confidence and knowledge, following training for teams that work together versus interprofessional groups from various teams. The project hoped to continue improving mental health simulation training and promote and enhance human factor skills that are basic pillars of multi-disciplinary and interprofessional care.MethodsThe human factors skills for healthcare instrument (HFSHI), alongside confidence and knowledge measures were administered to all participants pre and post simulation training on interacting mental and physical health. A post-course evaluation survey with open questions was used to collect qualitative feedback on the impact of the training course.ResultsWith data collection ongoing, preliminary results indicate differences between team and non-team simulation training, with particularly interesting qualitative findings.ConclusionsLearning outcomes may differ for team versus non-team simulation training, evidencing the different value of these two training set-ups.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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