| 19949207 |
Kisely S, Campbell LA, Wang Y: Treatment of ischaemic heart disease and stroke in individuals with psychosis under universal healthcare. Br J Psychiatry. 2009 Dec;195(6):545-50.
BACKGROUND: Most data on the quality of vascular care for individuals with psychiatric conditions come from countries without universal healthcare. AIMS: To investigate the treatment of people with psychosis admitted for ischaemic heart disease or stroke under universal healthcare. METHOD: A population-based study of administrative data comparing Canadians with and without a history of schizophrenia or related psychosis (n = 65,039). RESULTS: Of 49 248 admissions for ischaemic heart disease, 1285 had a history of psychosis. Despite a higher 1-year mortality, they were less likely to receive guideline-consistent treatment: e.g. coronary artery bypass grafting (adjusted odds ratio (OR) = 0.35, 95% CI 0.25-0.48), beta-blockers (adjusted OR = 0.82, 95% CI 0.71-0.95) and statins (adjusted OR = 0.51, 95% CI 0.41-0.63). Of 15 791 admissions for stroke, 594 had a history of psychosis. Despite higher 1-year mortality rates, they were less likely to receive cerebrovascular arteriography or warfarin. CONCLUSIONS: People with a history of psychosis do not receive equitable levels of vascular care under universal healthcare. |
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