TY - JOUR
T1 - Indicators of quality of diabetes care in persons with type 2 diabetes with and without severe mental illness
T2 - A Danish nationwide register-based cohort study
AU - Knudsen, Lenette
AU - Scheuer, Stine H.
AU - Diaz, Lars J.
AU - Jackson, Caroline A.
AU - Wild, Sarah H.
AU - Benros, Michael E.
AU - Hansen, Dorte L.
AU - Jørgensen, Marit E.
AU - Andersen, Gregers S.
N1 - Funding Information:
This study was funded by Steno Diabetes Center Copenhagen through an unrestricted grant from Novo Nordisk Foundation.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, Boehringer Ingelheim, Novo Nordisk and Sanofi Aventis, GSA: holds shares in Novo Nordisk A/S.
Publisher Copyright:
© 2022 The Authors
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Comorbidity
KW - Quality of care
KW - Severe mental illness
KW - Type 2 diabetes
UR - http://www.scopus.com/inward/record.url?scp=85144445328&partnerID=8YFLogxK
U2 - 10.1016/j.lanepe.2022.100565
DO - 10.1016/j.lanepe.2022.100565
M3 - Journal article
AN - SCOPUS:85144445328
JO - The Lancet regional health. Europe
JF - The Lancet regional health. Europe
SN - 2666-7762
M1 - 100565
ER -