General practitioner management of chronic diseases in adults with severe mental illness: a community intervention trial

摘要

Objective. The aim of the present study was to assess the effects of a community intervention aimed at generalpractitioners (GPs) by comparing Medicare claims data from patients with severe mental illness (SMI) of GPs exposed to theintervention and controls that were not.Methods. A comparison was made of primary care consultation and pathology data of people with SMI fromintervention and control areas. Negative binomial regression models were used to compare the frequency and length of GPconsultations, as well as the number and type of pathology examinations.Results. Records of 103 people from intervention area and 98 controls were obtained. Intervention and control areaswere not different at baseline in terms of age and claims data, but females had higher consultation rates. After adjusting forgender, people from intervention areas had more GP consultations, especially long consultations (adjusted incidence rateratio 1.56; 95% confidence interval 1.28–1.91). They also had more pathology screening for chronic diseases, in accordancewith implemented guideline recommendations. These benefits persisted after the end of the intervention.Conclusion. These findings suggest that the ACTIVATE program aimed at training GPs to screen and better managechronic diseases in adults with SMI had a positive effect up to 6 months after the trial, with demonstrated desired changesin medical management practices by GPs in the intervention area during that time.