March. 1, 2017 -- In a new study published today in General Hospital Psychiatry, researchers at the Centre for Addiction and Mental Health
(CAMH) and the Institute for
Clinical Evaluative Sciences (ICES) have highlighted the urgent need for
individuals with severe mental illness to receive better, integrated health
care for their co-existing diabetes condition.
study was based on records of more than one million Ontarians with diabetes, of
whom 2.3 per cent had schizophrenia. These latter individuals faced poorer
quality of care compared to other people with diabetes. On average, the lives
of these individuals are 15 to 20 years shorter than individuals without a
serious mental illness, and this reduced life span has been attributed to
cardiovascular illnesses, with diabetes being a major risk factor.
is no question that we simply have to do better to integrate mental and
physical healthcare for these individuals,” says Dr. Paul Kurdyak, senior
author and Director of Health Outcomes with the Medical Psychiatry Alliance (MPA), which supported the study. “Our
work highlights the urgent need to improve on the quality gaps identified in
this study.” Dr. Kurdyak is also a scientist and Medical Director of Performance
Improvement at CAMH, a scientist at ICES and an associate professor at the
University of Toronto.
in this study identified all Ontario residents with diabetes as of April 1,
2011, with and without a diagnosis of schizophrenia. The study looked at the
quality of diabetes care provided to both groups and diabetes-related Emergency
Department visits and hospitalizations over a two-year period.
found that individuals with schizophrenia received poorer quality of care for
their diabetes, and had worse diabetes-related outcomes. Three out of four did
not receive guideline-level diabetes care, versus two out of three individuals
without schizophrenia, despite having more access to primary care physicians
than those without schizophrenia. They were also 34 per cent more likely to
have diabetes-related hospitalizations after researchers adjusted for age, sex,
rurality, material deprivation, comorbidities and duration of diabetes.
know that providing high quality medical and psychiatric care to individuals
with both a physical illness and severe mental illness is challenging. We do
not have much evidence on how to address these deficits in quality of care or
poor outcomes in this population,” says Dr. Kurdyak. “We really need to develop
more innovative and integrated ways to address both mental and physical illness
in a large population that is burdened by both types of conditions.”
Medical Psychiatry Alliance is a collaborative health partnership of CAMH, The
Hospital for Sick Children, Trillium Health Partners, the University of
Toronto, the Ministry of Health and Long-Term Care (MOHLTC), and an anonymous
donor. The MPA is currently developing interventions to improve the quality of
care and quality of life for individuals with mental and physical illnesses.
The study, which used population-based data to understand the burden of illness
for individuals with a serious mental illness and diabetes, serves as a
baseline effort to improve the quality of care for these individuals.
study was also supported by ICES and grants from the MOHLTC.
For more information
Sandeep Dhaliwal, Senior Communications Advisor
Medical Psychiatry Alliance