Background
Methods
Setting and participants
Data collection procedures
Measures
Statistical analysis
Results
Full sample | White | Asian/Asian British | Black/Black British | Chinese/ Other | Mixed | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) | ANOVA/ χ2 | |
Total | 10,504 | 8368 | 861 | 883 | 183 | 209 | |||||||
Mean age in years (SD) | 46.7 | (13.4) | 42.0 | (12.2) | 43.0 | (11.9) | 45.4 | (13.7) | 38.7 | (12.0) | F = 52.6; p < 0.001 | ||
Sex | |||||||||||||
Male | 6834 | 65% | 5463 | 65% | 538 | 62% | 570 | 65% | 117 | 64% | 146 | 70% | χ2 = 5.01; p = 0.29 |
Female | 3670 | 35% | 2905 | 35% | 323 | 38% | 313 | 35% | 66 | 36% | 63 | 30% | |
Diagnosis | |||||||||||||
F20 (schizophrenia) | 8854 | 84% | 7010 | 84% | 743 | 86% | 778 | 88% | 147 | 80% | 176 | 84% | χ2 = 16.21; p = 0.003 |
F25 (schizoaffective disorder) | 1650 | 16% | 1358 | 16% | 118 | 14% | 105 | 12% | 36 | 20% | 33 | 16% | |
Duration of illness | |||||||||||||
1–2 years | 466 | 4% | 330 | 4% | 51 | 6% | 55 | 6% | 14 | 8% | 16 | 8% | χ2 = 123.69; p < 0.001 |
2–4 years | 961 | 9% | 695 | 8% | 106 | 12% | 107 | 12% | 22 | 12% | 31 | 15% | |
4–10 years | 2607 | 25% | 1982 | 24% | 270 | 31% | 252 | 29% | 49 | 27% | 54 | 26% | |
10+ years | 6470 | 62% | 5361 | 64% | 434 | 50% | 469 | 53% | 98 | 54% | 108 | 52% | |
Level of remission | |||||||||||||
Full/partial | 7711 | 73% | 6168 | 74% | 617 | 72% | 633 | 72% | 137 | 75% | 156 | 75% | χ2 = 3.44; p = 0.49 |
Significant disability or no remission | 2793 | 27% | 2200 | 26% | 244 | 28% | 250 | 28% | 46 | 25% | 53 | 25% | |
Clinical team responsible for care | |||||||||||||
Community mental health team | 7435 | 71% | 6062 | 72% | 597 | 69% | 532 | 60% | 131 | 72% | 113 | 54% | χ2 = 137.93; p < 0.001 |
Assertive outreach team | 1294 | 12% | 1004 | 12% | 93 | 11% | 143 | 16% | 14 | 8% | 40 | 19% | |
Early intervention | 520 | 5% | 338 | 4% | 66 | 8% | 75 | 8% | 14 | 8% | 27 | 13% | |
Other incl. crisis resolution team | 1255 | 12% | 964 | 12% | 105 | 12% | 133 | 15% | 24 | 13% | 29 | 14% |
Full sample | White | Asian/ Asian British | Black / Black British | Chinese/ Other | Mixed | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) |
N
| (%) | χ
2
; p value | |
Totals | 10,504 | 8368 | 861 | 883 | 183 | 209 | |||||||
Antipsychotic prescribing | |||||||||||||
In receipt of an antipsychotic | 10,111 | 96% | 8068 | 96% | 828 | 96% | 839 | 95% | 174 | 95% | 202 | 97% | χ2 = 5.16; p = 0.27 |
Prescribed SGA vs FGAa | 4396 | 65% | 3362 | 64% | 428 | 70% | 418 | 63% | 97 | 73% | 91 | 68% | χ2 = 13.41; p = 0.009 |
Prescribed depot | 3336 | 32% | 2640 | 32% | 257 | 30% | 335 | 38% | 46 | 25% | 58 | 28% | χ2 = 22.4; p < 0.001 |
Prescribed clozapineb | 719 | 26% | 589 | 27% | 57 | 23% | 46 | 18% | 12 | 26% | 15 | 28% | χ2 = 9.18; p = 0.06 |
Prescribed > 100% BNF recommended dose | 1048 | 10% | 869 | 10% | 69 | 8% | 65 | 7% | 16 | 9% | 29 | 14% | χ2 = 15.82; p = 0.003 |
Prescribed 2+ antipsychotics, exc. clozapine | 1229 | 12% | 1019 | 12% | 91 | 11% | 78 | 9% | 16 | 9% | 25 | 12% | χ2 = 11.50; p = 0.02 |
Shared decision making | |||||||||||||
Service user involved in deciding which antipsychotic prescribed | 6070 | 59% | 4861 | 59% | 470 | 55% | 514 | 59% | 99 | 55% | 126 | 62% | χ2 = 6.17; p = 0.19 |
Provided with written info on medication or alternative | 4244 | 41% | 3373 | 40% | 349 | 41% | 367 | 42% | 71 | 39% | 84 | 41% | χ2 = 0.69; p = 0.95 |
Benefits/side effects of the antipsychotic explained | 7421 | 71% | 5885 | 71% | 604 | 70% | 650 | 74% | 125 | 69% | 157 | 76% | χ2 = 6.94; p = 0.14 |
Psychological treatments | |||||||||||||
CBT ever offered | 3578 | 34% | 2826 | 34% | 276 | 32% | 325 | 37% | 57 | 31% | 94 | 45% | χ2 = 16.60; p = 0.002 |
Family therapy ever offered | 1554 | 15% | 1176 | 14% | 187 | 22% | 114 | 13% | 36 | 20% | 41 | 20% | χ2=46.35; p < 0.001 |
Care planc | |||||||||||||
Service user has a current care plan | 5263 | 95% | 4208 | 96% | 408 | 91% | 435 | 96% | 98 | 91% | 114 | 98% | χ2 = 24.34; p < 0.001 |
Asian/Asian British | Black/Black British | Chinese/ Other | Mixed | LRT | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Number, N/ total | OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | p value | |
Antipsychotic prescribing | ||||||||||
Not in receipt of an antipsychotic | 393/10,504 | 1.01 | 0.69, 1.47 | 1.26 | 0.89, 1.77 | 1.24 | 0.62, 2.49 | 0.78 | 0.36, 1.70 | 0.66 |
Prescribed SGA vs FGAa | 4396/6769 | 0.91 | 0.75, 1.10 | 1.17 | 0.97, 1.41 | 0.72 | 0.48, 1.07 | 1.06 | 0.72, 1.56 | 0.13 |
Prescribed depot | 3336/10,504 | 1.07 | 0.90, 1.26 | 1.56 | 1.33, 1.84 | 0.83 | 0.59, 1.17 | 1.01 | 0.74, 1.40 | < 0.001 |
Prescribed clozapineb` | 719/2793 | 0.76 | 0.55, 1.06 | 0.56 | 0.39, 0.79 | 0.96 | 0.48, 1.92 | 1.10 | 0.58, 2.08 | 0.01 |
Prescribed > 100% BNF recommended dose | 1048/10,504 | 0.82 | 0.63, 1.08 | 0.77 | 0.58, 1.02 | 0.88 | 0.52, 1.50 | 1.58 | 1.05, 2.38 | 0.04 |
Prescribed 2+ antipsychotics, exc. clozapine | 1229/10,504 | 1.00 | 0.79, 1.28 | 0.86 | 0.66, 1.11 | 0.77 | 0.46, 1.31 | 1.20 | 0.79, 1.86 | 0.54 |
Shared decision making | ||||||||||
Service user involved in deciding which antipsychotic prescribed | 6070/10,334 | 0.85 | 0.73, 0.99 | 1.07 | 0.92, 1.26 | 0.93 | 0.68, 1.27 | 1.08 | 0.80, 1.45 | 0.17 |
Provided with written info on medication or alternative | 4244/10,455 | 0.97 | 0.83, 1.14 | 1.04 | 0.88, 1.22 | 0.96 | 0.70, 1.32 | 0.94 | 0.70, 1.27 | 0.96 |
Benefits/side effects of the antipsychotic explained | 7421/10,461 | 0.93 | 0.79, 1.10 | 1.15 | 0.96, 1.37 | 0.97 | 0.70, 1.35 | 1.20 | 0.86, 1.68 | 0.31 |
Psychological treatments | ||||||||||
CBT ever offered | 3578/10,495 | 0.73 | 0.61, 0.86 | 0.74 | 0.63, 0.88 | 0.69 | 0.49, 0.97 | 1.10 | 0.82, 1.48 | < 0.001 |
Family therapy ever offered | 1554/10,493 | 1.53 | 1.26, 1.86 | 0.76 | 0.60, 0.95 | 1.39 | 0.93, 2.06 | 1.01 | 0.70, 1.47 | < 0.001 |
Care planc | ||||||||||
Service user has a current care plan | 5263/5520 | 0.50 | 0.33, 0.76 | 1.29 | 0.74, 2.26 | 0.53 | 0.26, 1.10 | 2.38 | 0.56, 10.12 | 0.002 |