Indicators of quality of diabetes care in persons with type 2 diabetes with and without severe mental illness: a Danish nationwide register-based cohort study.

Autor:	Knudsen L; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark., Scheuer SH; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark., Diaz LJ; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark., Jackson CA; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom., Wild SH; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom., Benros ME; Biological and Precision Psychiatry, Copenhagen Research Centre for Mental Health, Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.; Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Hansen DL; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark., Jørgensen ME; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark.; Steno Diabetes Center Greenland, Nuuk, Greenland.; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark., Andersen GS; Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Europe [Lancet Reg Health Eur] 2022 Dec 16; Vol. 26, pp. 100565. Date of Electronic Publication: 2022 Dec 16 (Print Publication: 2023).
DOI:	10.1016/j.lanepe.2022.100565
Abstrakt:	Background: This study aims to examine quality of diabetes care in persons with type 2 diabetes with and without severe mental illness (SMI). Methods: In a nationwide prospective register-based study, we followed persons with type 2 diabetes in Denmark with and without SMI including schizophrenia, bipolar disorder, or major depression. Quality of care was measured as receipt of care (hemoglobin A1c, low-density lipoprotein-cholesterol and urine albumin creatinine ratio assessment and eye and foot screening) and achievement of treatment targets between 2015 and 2019. Quality of care was compared in persons with and without SMI using generalized linear mixed models adjusted for key confounders. Findings: We included 216,537 persons with type 2 diabetes. At entry 16,874 (8%) had SMI. SMI was associated with lower odds of receiving care, with the most pronounced difference in urine albumin creatinine ratio assessment and eye screening (OR: 0.55, 95% CI: 0.53-0.58 and OR: 0.37 95% CI: 0.32-0.42, respectively). Among those with an assessment, we found that SMI was associated with higher achievement of recommended hemoglobin A1c levels and lower achievement of recommended low-density lipoprotein-cholesterol levels. Achievement of recommended low-density lipoprotein-cholesterol levels was similar in persons with versus without schizophrenia. Interpretation: Compared to persons without SMI, persons with SMI were less likely to receive process of care, with the most pronounced differences in urine albumin creatinine ratio assessment and eye screening. Funding: This study was funded by Steno Diabetes Center Copenhagen through an unrestricted grant from Novo Nordisk Foundation. Competing Interests: LK: holds shares in Novo Nordisk A/S, SHS: none, LJD: none, CAJ: none, SHW: none, MEB: none, DLH: None, MEJ: holds shares in Novo Nordisk, has received research grants from AMGEN, Astra Zeneca, 10.13039/100001003Boehringer Ingelheim, Novo Nordisk and Sanofi Aventis, GSA: holds shares in Novo Nordisk A/S. (© 2022 The Authors.)
Databáze:	MEDLINE
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