CVD risk factor recording and QOF CVD target achievement by serious mental illness (SMI) status and among patients with CVD conditions
| Risk factor recording | Heart failure | Coronary heart disease | Hypertension | Stroke/transient ischaemic attack | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-SMI (n = 1259) | SMI (n = 45) | P-value | Non-SMI (n = 4109) | SMI (n = 97) | P-value | Non-SMI (n = 28 010) | SMI (n = 762) | P-value | Non-SMI (n = 2544) | SMI (n = 100) | P-value | |
| n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | |||||
| BP record | 1251 (99.4) | 44 (97.8) | 0.206 | 4079 (99.3) | 94 (96.9) | 0.009b | 27 859 (99.5) | 754 (99.0) | 0.061 | 2519 (99.0) | 96 (96.0) | 0.004b |
| Smoking status record | 1257 (99.8) | 45 (100.0) | 0.789 | 4099 (99.8) | 96 (99.0) | 0.133 | 27 977 (99.9) | 759 (99.6) | 0.034a | 2537 (99.7) | 97 (97.0) | <0.001c |
| HbA1c record | 805 (63.9) | 26 (57.8) | 0.398 | 2728 (66.4) | 67 (69.1) | 0.580 | 16 468 (58.8) | 531 (69.7) | <0.001c | 1544 (60.7) | 69 (69.0) | 0.095 |
| Cholesterol record | 1206 (95.8) | 45 (100.0) | 0.160 | 4017 (97.8) | 94 (96.9) | 0.576 | 26 880 (96.0) | 734 (96.3) | 0.618 | 2441 (96.0) | 94 (94.0) | 0.336 |
| BMI record | 1187 (94.3) | 45 (100.0) | 0.099 | 3849 (93.7) | 94 (96.9) | 0.193 | 26 386 (94.2) | 743 (97.5) | <0.001c | 2317 (91.1) | 95 (95.0) | 0.174 |
| Alcohol record | 992 (78.8) | 45 (100.0) | 0.001c | 3325 (80.9) | 88 (90.7) | 0.015a | 22 637 (80.8) | 716 (94.0) | <0.001c | 1966 (77.3) | 92 (92.0) | 0.001c |
| eGFR record | 1229 (97.6) | 44 (97.8) | 0.945 | 3987 (97.0) | 94 (96.9) | 0.943 | 26 854 (95.9) | 731 (95.9) | 0.936 | 2415 (94.9) | 96 (96.0) | 0.631 |
| CVD risk factor assessment | 236 (18.8) | 10 (22.2) | 0.558 | 727 (17.7) | 11 (11.3) | 0.104 | 9995 (35.6) | 230 (30.2) | 0.002b | 460 (18.1) | 14 (14.0) | 0.297 |
| TSH record | 1140 (90.6) | 40 (88.9) | 0.709 | 3619 (88.1) | 85 (87.6) | 0.893 | 23 884 (85.3) | 677 (88.9) | 0.006b | 2142 (84.2) | 86 (86.0) | 0.627 |
| CHD comorbidity | 569 (45.2) | 13 (28.9) | 0.031a | – | – | – | 2590 (9.3) | 57 (7.5) | 0.096 | 454 (17.9) | 19 (19.0) | 0.768 |
| DM comorbidity | 428 (34.0) | 17 (37.8) | 0.599 | 1294 (31.5) | 31 (32.0) | 0.922 | 6837 (24.4) | 276 (36.2) | <0.001c | 647 (25.4) | 36 (36.0) | 0.018a |
| HYP comorbidity | 886 (70.4) | 27 (60.0) | 0.136 | 2590 (63.0) | 57 (58.8) | 0.389 | – | – | – | 1680 (66.0) | 66 (66.0) | 0.994 |
| QOF target achievementd | ||||||||||||
| Last BP record within 9 months | – | – | – | – | – | – | 18 286 (65.3) | 500 (65.6) | 0.849 | – | – | – |
| Normal BP (150/90 mmHg) in last 9 months | – | – | – | – | – | – | 20 829 (74.4) | 557 (73.1) | 0.430 | 1907 (75.0) | 67 (67.0) | 0.073 |
| Normal BP (150/90 mmHg) in last 15 months | – | – | – | 3451 (84.0) | 80 (82.5) | 0.688 | – | – | – | – | – | – |
| Cholesterol record in last 15 months | 1786 (70.2) | 69 (69.0) | 0.796 | |||||||||
| Cholesterol <5 mmol/l in last 15 months | – | – | – | 2816 (68.5) | 58 (59.8) | 0.067 | – | – | – | 1477 (56.9) | 52 (52.0) | 0.334 |
| Anticoagulant/antiplatelet last 15 months | – | – | – | 3002 (73.1) | 69 (71.1) | 0.667 | – | – | – | 1460 (61.7) | 59 (62.8) | 0.840e |
| Quadruple therapyf | – | – | – | 1530 (51.9) | 28 (41.2) | 0.082 | – | – | – | – | – | – |
| Beta blocker | 879 (69.8) | 18 (40.0) | <0.001c | 2710 (66.0) | 53 (54.6) | 0.020b | – | – | – | – | – | – |
| ACEI/ARB | 1051 (83.5) | 28 (62.2) | <0.001c | – | – | – | – | – | – | – | – | – |
ACEI/ARB = angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. BMI = body mass index. BP = blood pressure. CHD = coronary heart disease. CVD = cardiovascular disease. DM = diabetes mellitus. EGFR = estimated glomerular filtration rate. HbA1c = glycated haemoglobin. HYP = hypertension. MI = myocardial infarction. QOF = Quality and Outcomes Framework. TSH = thyroid stimulating hormone.
↵a P <0.05.
↵b P<0.01.
↵c P<0.001.
↵d Refers to QOF guidelines 2012/13.17
↵e If non-haemorrhagic (non-SMI n = 2366, SMI n = 94).2 If registered with MI (non-SMI n = 2951, SMI n = 68). All QOF management guidelines refer to records since registration with outcomes.
↵f MI drugs —‘quadruple therapy’ including statin, antiplatelet/anticoagulant, beta blocker, and ACEI/ARB prescription.