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Dr David Shiers Archives - Page 2 of 3 - Psychosis Research Unit
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Dr David Shiers

Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care

Moore S, Shiers D, Daly B, Mitchell AJ, Gaughran F Full Article Abstract OBJECTIVE: Acquiring a diagnosis of schizophrenia reduces life expectancy for many reasons including poverty, difficulties in communication, side-effects of medication and access to care. This mortality gap is driven by natural deaths; cardiovascular disease is a major cause, but outcomes for people with severe mental illness are worse for many physical health conditions, including cancer, fractures and complications of surgery. We set out to examine the literature on disparities in medical and dental care experienced by people with schizophrenia and suggest possible approaches to improving health. METHOD: This narrative review used a targeted literature search to identify the literature on physical health disparities in schizophrenia. RESULTS: There is evidence of inequitable access to and/or uptake of physical...

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Don’t just screen intervene; a quality improvement initiative to improve physical health screening of young people experiencing severe mental illness

Greenwood P & Shiers D Full Article Abstract Purpose – The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular disease (CVD), diabetes and obesity, major contributors to poor physical health and risk of premature mortality. Design/methodology/approach – The first phase of the AQuA “Don’t just screen-intervene” initiative supported five specialised community-based Early Intervention for Psychosis services in North West England to assess the effectiveness of monitoring of cardiometabolic risk in their patients using standards derived from the Lester Positive Cardiometabolic Health Resource, a nationally acknowledged framework for people with psychosis receiving antipsychotic medication. The initial findings formed the basis for a quality improvement programme which ran from November 2012...

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Health inequalities and psychosis: time for action.

Shiers D1, Bradshaw T2, Campion J2. Full Article Abstract People with psychosis face a life-restricting and life-shortening epidemic of obesity, diabetes and cardiovascular disease. This can be predicted by the associated antecedent risk factors evident from early in psychosis, yet remain largely ignored. Greater coordination between primary care, secondary care and public health to systematically prevent and intervene earlier for these physical illnesses offers a realistic solution to reduce this health inequality....

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Understanding the needs of carers of people with psychosis in primary care

Juliana Onwumere, David Shiers and Carolyn Chew-Graham Full Article INTRODUCTION A couple you have known for years consult with you; they are in despair. Their son’s new psychiatric team has just advised them that, as he is now an adult, he will be able to make his own decisions without his parents attending routine appointments. They have watched their son’s prospects for a normal life disintegrate over the last 2 years — rarely leaving his room, losing his friends, and spending most days without structure or purpose. Many individuals diagnosed with psychotic conditions live with, or remain in close contact with, informal caregivers, typically close relatives such as their parents, partners, siblings, and children. As in the scenario above, the experience of a family member developing psychosis leaves...

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Loss of relational continuity of care in schizophrenia: associations with patient satisfaction and quality of care

Rahil Sanatinia, Violet Cowan, Kirsten Barnicot, Krysia Zalewska, David Shiers, Stephen J. Cooper, and Mike J. Crawford Full Article Abstract Background Users of mental health service are concerned about changes in clinicians providing their care, but little is known about their impact. Aims To examine associations between changes in staff, and patient satisfaction and quality of care. Method A national cross-sectional survey of 3379 people aged 18 or over treated in secondary care for schizophrenia or schizoaffective disorder. Results Nearly 41.9% reported at least one change in their key worker during the previous 12 months and 10.5% reported multiple changes. Those reporting multiple changes were less satisfied with their treatment and less likely to report having a care plan, knowing how to obtain help when in a crisis or to have...

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