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Using electronic medical records to determine prevalence and treatment of mental disorders in primary care: a database study

Published online by Cambridge University Press:  10 April 2015

M. Gleeson ,
A. Hannigan ,
R. Jamali ,
K. Su Lin ,
J. Klimas ,
M. Mannix ,
Y. Nathan ,
R. O’Connor ,
C. O’Gorman  and
C. Dunne
...Show all authors
M. Gleeson
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
A. Hannigan
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
R. Jamali
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
K. Su Lin
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
J. Klimas
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
M. Mannix
Affiliation:
Department of Public Health, Health Services Executive West, Limerick, Ireland
Y. Nathan
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
R. O’Connor
Affiliation:
HSE Midwest/UL Specialist GP Training Programme, Limerick, Ireland
C. O’Gorman
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
C. Dunne
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
D. Meagher
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland
W. Cullen*
Affiliation:
Graduate-Entry Medical School, University of Limerick, Limerick, Ireland UCD School of Medicine & Medical Science, Dublin, Ireland
*
*Address for correspondence: Professor W. Cullen, UCD School of Medicine & Medical Science, UCD Health Sciences, Belfield, Dublin 4, Ireland. (Email: [email protected])
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Abstract

Objectives

With prevention and treatment of mental disorders a challenge for primary care and increasing capability of electronic medical records (EMRs) to facilitate research in practice, we aim to determine the prevalence and treatment of mental disorders by using routinely collected clinical data contained in EMRs.

Methods

We reviewed EMRs of patients randomly sampled from seven general practices, by piloting a study instrument and extracting data on mental disorders and their treatment.

Results

Data were collected on 690 patients (age range 18–95, 52% male, 52% GMS-eligible). A mental disorder (most commonly anxiety/stress, depression and problem alcohol use) was recorded in the clinical records of 139 (20%) during the 2-year study period. While most patients with the common disorders had been prescribed medication (i.e. antidepressants or benzodiazepines), a minority had been referred to other agencies or received psychological interventions. ‘Free text’ consultation notes and ‘prescriptions’ were how most patients with disorders were identified. Diagnostic coding alone would have failed to identify 92% of patients with a disorder.

Conclusions

Although mental disorders are common in general practice, this study suggests their formal diagnosis, disease coding and access to psychological treatments are priorities for future research efforts.

Keywords

General practicehealth informaticsmental disordersprimary healthcaresubstance use
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 33 , Issue 1 , March 2016 , pp. 3 - 12
Copyright
© College of Psychiatrists of Ireland 2015 

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