M-PHiL Study - Mental and Physical Health in Lambeth

M-PHiL 研究 - 兰贝斯的心理和身体健康

• 批准号: MR/J013471/1
• 负责人: Max Henderson
• 金额: $ 23.13万
• 依托单位: King's College London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2013
• 资助国家: 英国
• 起止时间: 2013 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FJ013471%2F1
• 关键词: PHiL; Study; Mental; Physical; Health

The MRC 2010 review of mental health research underlined the importance of understanding the links between physical illness and poor mental health and noted the difficulties faced by some patients in obtaining satisfactory treatment when mental and physical conditions co-occur. The report called for an improvement in access to anonymised data based on NHS contact "for example, by data linkage across cohorts".We plan to link Lambeth Data Net (LDN) established by Lambeth Primary Care Trust (PCT) containing the primary healthcare records from patients from all but two GP practices in the London Borough of Lambeth (population ~ 300 000) with CRIS, the Case Register Interactive Search system containing the entire electronic patient record of the South London & Maudsley Trust, the sole provider of NHS mental health services to patients in Lambeth (n=180000 of whom 36 000 live in Lambeth). The Caldicott Guardians for SLAM and for Lambeth PCT have both already approved the linkage plans. Each dataset has been linked before - LDN with primary care databases in east and south-west London and CRIS with the Thames Cancer Registry and Hospital Episode Statistics data. The study will be based in the Biomedical Research Centre for Mental Health, recently given a national leadership role to develop e-health for research in recognition of the advances made by CRIS.The aim of the study is to generate a unique resource to improve research into the course and outcomes of mental ill health. Specifically our objectives are: [1] to create a one-off link between two established datasets containing information on the health of an entire London borough [2] to demonstrate the utility of this new dataset by using it to examine in detail why some patients with severe mental illness have excellent physical health and some very poor physical health [3] to develop the methods to be able to update the linkage so that the impact of any interventions we might develop from the proposed work can be assessed in real time.Addressing health inequalities is a major area of interest both nationally and locally within London. Patients with severe mental illness such as schizophrenia have worse physical health than the general population- in south London we have shown that patients with severe mental illness die up to 17 years early. Whilst we know that on average patients with severe mental illness have more risk factors for poor physical health & they seem less likely to be offered the best medical care in hospital, we know little about which individual factors (e.g. ethnicity), disease factors (e.g. medication) and systemic factors (e.g. single-handed GP) are associated with good and bad physical health. Creating from scratch a dataset detailed enough to answer these questions would be prohibitively expensive but by linking two datasets comprising routinely collected data on the whole population (~36 000 in both datasets) we have sufficient data on sufficient individuals to address all these important issues.In meeting the challenges thrown down by the 2010 MRC Review head on, our proposal has the potential to deliver both clinically and academically. Our study, linking the complete primary care and mental health records of one ethnically diverse London borough, is population-based and uses datasets specifically designed to enhance ease of access and which have themselves already produced major research findings. Our study will produce a methodological template for other groups wishing to exploit the possibilities of data linkage, a linked dataset that can be interrogated to address multiple issues of physical and mental comorbidity locally and beyond, and will provide a structure to monitor any interventions arising from such analyses almost in real time.

2010 年 MRC 对心理健康研究的回顾强调了了解身体疾病与不良心理健康之间联系的重要性，并指出了一些患者在精神和身体状况同时出现时难以获得满意的治疗。该报告呼吁改善基于 NHS 联系方式的匿名数据的访问，“例如，通过队列之间的数据链接”。我们计划链接兰贝斯初级保健信托基金 (PCT) 建立的兰贝斯数据网 (LDN)，其中包含初级医疗保健记录来自伦敦兰贝斯区（人口约 300 000）除两家全科医生诊所外的所有患者，使用 CRIS 进行病例注册交互式搜索系统，其中包含南伦敦和莫兹利的完整电子患者记录Trust 是为兰贝斯患者（n=180000，其中 36,000 人居住在兰贝斯）提供 NHS 心理健康服务的唯一提供商。 SLAM 和 Lambeth PCT 的 Caldicott Guardians 都已经批准了联动计划。每个数据集之前都已链接 - LDN 与伦敦东部和西南部的初级保健数据库以及 CRIS 与泰晤士癌症登记处和医院发病统计数据。该研究将在心理健康生物医学研究中心进行，该中心最近被赋予了国家领导地位，以开发电子健康研究，以表彰 CRIS 所取得的进步。该研究的目的是生成一种独特的资源来改进研究深入了解精神疾病的过程和结果。具体来说，我们的目标是：[1] 在两个已建立的数据集之间创建一次性链接，其中包含整个伦敦行政区的健康信息 [2] 通过使用它来详细检查某些患者的健康原因来展示这一新数据集的实用性患有严重精神疾病的人有良好的身体健康状况和一些非常差的身体健康状况[3]，以开发能够更新联系的方法，以便可以实时评估我们可能从拟议工作中开发的任何干预措施的影响。健康不平等是一个主要关注领域全国和伦敦本地。患有精神分裂症等严重精神疾病的患者的身体健康状况比一般人群更差——在伦敦南部，我们发现患有严重精神疾病的患者最多可以提前 17 年死亡。虽然我们知道，平均而言，患有严重精神疾病的患者有更多身体健康状况不佳的危险因素，而且他们似乎不太可能在医院获得最好的医疗护理，但我们对哪些个人因素（例如种族）、疾病因素（例如种族）知之甚少。药物）和全身因素（例如单手全科医生）与身体健康状况的好坏相关。从头开始创建一个足够详细的数据集来回答这些问题将非常昂贵，但通过链接两个包含常规收集的整个人口数据的数据集（两个数据集中约 36 000 人），我们拥有足够多的个人数据来解决所有这些重要问题。为了应对 2010 年 MRC 审查提出的挑战，我们的提案有可能在临床和学术上取得成果。我们的研究将伦敦一个种族多元化行政区的完整初级保健和心理健康记录联系起来，以人口为基础，并使用专门为提高访问便利性而设计的数据集，这些数据集本身已经产生了重大研究成果。我们的研究将为其他希望利用数据链接可能性的团体提供一个方法模板，一个链接的数据集，可以被询问以解决本地和其他地区的身心共病的多种问题，并将提供一个结构来监测因以下原因而产生的任何干预措施：此类分析几乎是实时的。

项目成果

Cohort profile of the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register: current status and recent enhancement of an Electronic Mental Health Record-derived data resource.

• DOI: 10.1136/bmjopen-2015-008721
• 发表时间: 2016-03-01
• 期刊: BMJ open
• 影响因子: 2.9
• 作者: Perera G;Broadbent M;Callard F;Chang CK;Downs J;Dutta R;Fernandes A;Hayes RD;Henderson M;Jackson R;Jewell A;Kadra G;Little R;Pritchard M;Shetty H;Tulloch A;Stewart R
• 通讯作者: Stewart R

Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study.

• DOI: 10.1186/1471-2296-15-117
• 发表时间: 2014-06-11
• 期刊: BMC family practice
• 影响因子: 2.9
• 作者: Woodhead C;Ashworth M;Schofield P;Henderson M
• 通讯作者: Henderson M

Cervical and breast cancer screening uptake among women with serious mental illness: a data linkage study.

• DOI: 10.1186/s12885-016-2842-8
• 发表时间: 2016-10-21
• 期刊: BMC cancer
• 影响因子: 3.8
• 作者: Woodhead C;Cunningham R;Ashworth M;Barley E;Stewart RJ;Henderson MJ
• 通讯作者: Henderson MJ

Cardiovascular disease treatment among patients with severe mental illness: a data linkage study between primary and secondary care.

• DOI: 10.3399/bjgp16x685189
• 发表时间: 2016-06
• 期刊: The British journal of general practice : the journal of the Royal College of General Practitioners
• 作者: Woodhead C;Ashworth M;Broadbent M;Callard F;Hotopf M;Schofield P;Soncul M;Stewart RJ;Henderson MJ
• 通讯作者: Henderson MJ

Seeking informal and formal help for mental health problems in the community: a secondary analysis from a psychiatric morbidity survey in South London.

为社区中的心理健康问题寻求非正式和正式的帮助：伦敦南部精神病发病率调查的二次分析。

• DOI: 10.1186/preaccept-2067133308130116
• 发表时间: 2014
• 期刊: BMC psychiatry
• 影响因子: 4.4
• 作者: Brown J