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.

MRC 2010对心理健康研究的评论强调了了解身体疾病与精神健康不良之间联系的重要性，并注意到某些患者在同时发生的心理和身体状况时遇到的令人满意的治疗方面所面临的困难。 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伦敦和莫德斯利信托（London＆Maudsley Trust），唯一的NHS心理健康服务提供商，兰贝斯（N = 180000），其中36000人居住在兰贝斯（Lambeth））。 Caldicott Guardians的SLAM和LAMBETH PCT都已经批准了连锁计划。每个数据集之前已将其链接到伦敦东部和西南部的初级保健数据库，以及泰晤士河癌症注册表和医院发作统计数据。该研究将基于生物医学研究中心的心理健康研究中心，最近扮演了国家领导角色，以开发电子健康以表彰CRIS的进步。该研究的目的是生成独特的资源，以改善对心理健康状况的过程和成果的研究。具体而言，我们的目标是：[1]在两个既定数据集之间建立一个一次性链接，该数据集包含有关整个伦敦自治市镇健康的信息[2]，以证明该新数据集的实用性，以详细检查它来详细检查某些患有严重精神疾病的患者为什么具有良好的身体健康和一些非常差的身体健康[3]可以更新链接的方法，从而使我们能够更新链接，从而使我们能够更新该互动，以使我们能够开发该互动，使我们能够进行互动，从而使该互动效果不断效果。 Time.Address Address whealt不平等是伦敦境内的全国和本地关注的主要领域。患有严重精神疾病（例如精神分裂症）的患者的身体健康状况要比一般人群差 - 我们已经表明，患有严重精神疾病的患者死于早期17年。尽管我们知道，患有严重精神疾病的患者的身体健康状况不佳，并且似乎不太可能提供医院的医疗服务，但我们对哪些个人因素（例如种族）（例如，药物）（例如，全身因素）（例如，单身GP）与身体健康相关，疾病因素（例如，毒品）和身体健康。创建一个足够详细的数据集以回答这些问题的数据集将非常昂贵，但是通过将两个数据集链接到包含整个人群的数据（在两个数据集中〜36000）的数据集中，我们就有足够的个人数据来解决所有这些重要问题。我们的研究将一个种族多元化的伦敦自治市镇的完整初级保健和心理健康记录联系起来，是基于人群的，并使用专门设计的数据集来增强访问性，并且本身已经产生了主要的研究结果。我们的研究将为希望利用数据链接的可能性的其他群体生成方法学模板，该链接的数据集可以询问，以解决本地及以后的物理和精神合并症的多个问题，并将提供一种结构，以监视几乎实时通过此类分析引起的任何干预措施。

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