2 research outputs found
To what extent are psychiatrists aware of the comorbid somatic illnesses of their patients with serious mental illnesses? – a cross-sectional secondary data analysis
Background Somatic comorbidities are a serious problem in patients with severe
mental illnesses. These comorbidities often remain undiagnosed for a long
time. In Germany, physicians are not allowed to access patients’ health
insurance data and do not have routine access to documentation from other
providers of health care. Against this background, the objective of this
article was to investigate psychiatrists’ knowledge of relevant somatic
comorbidities in their patients with severe mental illnesses. Methods Cross-
sectional secondary data analysis was performed using primary data from a
prospective study evaluating a model of integrated care of patients with
serious mental illnesses. The primary data were linked with claims data from
health insurers. Patients’ diagnoses were derived on the basis of the ICD-10
and the Anatomical Therapeutic Chemical (ATC) classification system. Diabetes,
hypertension, coronary artery disease (CAD), hyperlipidaemia, glaucoma,
osteoporosis, polyarthritis and chronic obstructive pulmonary disease (COPD)
were selected for evaluation. We compared the number of diagnoses reported in
the psychiatrists’ clinical report forms with those in the health insurance
data. Results The study evaluated records from 1,195 patients with severe
mental illnesses. The frequency of documentation of hypertension ranged from
21% in claims data to 4% in psychiatrists’ documentation, for COPD from 12 to
0%, respectively, and for diabetes from 7 to 2%, respectively. The percentage
of diagnoses deduced from claims data but not documented by psychiatrists
ranged from 68% for diabetes and 83% for hypertension, to 90% for CAD to 98%
for COPD. Conclusions The majority of psychiatrists participating in the
integrated care programme were insufficiently aware of the somatic
comorbidities of their patients. We support allowing physicians to access
patients’ entire medical records to increase their knowledge of patients’
medical histories and, consequently, to increase the safety and quality of
care