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- W3200873025 abstract "Mental health problems affect at least 1 in 4 people, cost the UK £105 billion annually and represent 28% of the total UK disease burden affecting all levels of society.1 Internationally, mental health accounts for 1 in 5 years lived with disability, and in 2019 WHO launched a special initiative specifically focused on mental health.2 COVID-19 is widely acknowledged to have increased this burden; early research identified a reduction in reported problems, but this most likely simply reflects the difficulty in accessing healthcare because many non-COVID services had limited capacity.3 Primary care is key to identifying and managing people with mental health problems; data from England suggest that 40% of general practitioner (GP) consultations involve mental health problems, and 30% to 50% of people with severe mental illness (SMI) such as psychosis or bipolar disorder are solely supported by primary care without specialist input.4 Internationally, the WHO special initiative also identified the importance of primary care.2Medication to reduce symptoms is one of the main treatments for people with SMI, who are frequently prescribed complex regimens including medication for both mental and physical conditions. However, such medications have potentially significant adverse consequences. For instance, antipsychotics are associated with an increased prevalence of cardiometabolic risk, metabolic syndrome and related diseases including dyslipidaemia, impaired glucose tolerance and weight gain and cardiovascular disease, which can lead to ‘cascade prescribing’ as other medications are then needed to manage these effects.5 Such cascade prescribing may not only be associated with adverse events including additional physical health problems, but such complex regimens are also more difficult for patients to manage.6 Prescribing medication for people with SMI should therefore be coupled with monitoring of the physical health problems that may occur.Other factors also increase the frequency of physical health problems …" @default.
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- W3200873025 date "2021-09-23" @default.
- W3200873025 modified "2023-10-18" @default.
- W3200873025 title "Challenge of optimising medication in people with severe mental illness" @default.
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- W3200873025 doi "https://doi.org/10.1136/bmjqs-2021-013847" @default.
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