Mental and behavioural disorders are a range of conditions that affect thought, emotions or behaviour. Conditions such as learning disability may present from birth, others such as bi-polar disorder, have a strong genetic component but become apparent later in life whereas others may come and go in response to environmental triggers . Mental and behavioural disorders are common with approximately 25% of the population likely to report a condition during their lifetime. The impact on the individual can vary depending on the nature of the condition; those most severe such as schizophrenia, have a profound effect on quality of life and are associated with reduced life expectancy. In addition, these conditions place a large financial burden with annual societal costs of over £100 billion. The aim of this study is to describe the number of people who have mental and behavioural disorders in the UK and estimate their healthcare costs. How often a disease occurs in our population plays an important role in planning NHS services and highlighting areas for future research and development.
Patients with mental and behavioural disorders will be selected from CPRD. The number of people developing the condition (incidence) will be calculated on a yearly basis for the duration of the data source, and the proportion of people having that condition at the midyear point (point prevalence) will be calculated. Time to death and patients’ characteristics will be presented. The frequency and cost of primary care consultations, prescriptions, outpatient attendances and inpatient stays will be determined.
We aim to determine the descriptive epidemiology of mental and behavioural disorders and estimate and cost healthcare use by people with these conditions. Acceptable patients will be selected from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets if they have a medical code indicative of a mental and behavioural disorder . For sensitivity analyses, a sub-cohort will comprise English patients eligible for linkage to the HES admitted patient care (APC) and outpatient datasets, and their Office for National Statistics (ONS) death registration data. The start of CPRD follow-up will be defined as the later of the patient’s registration date and, in CPRD GOLD, their practice’s up-to-standard date; the end of CPRD data follow-up will be defined as the earliest of the patient’s transfer-out date, date of death (if applicable), and the last data-collection date for their practice. The presentation date will be defined as that of the patient’s first ever record with a code indicative of a mental or behavioural disorder . Incident patients will be selected if their presentation date occurs at least 90 days after registration. Time to death will be presented using Kaplan–Meier analysis. Healthcare resource use and associated costs will be estimated before and after presentation and comprise primary care contacts, primary care prescriptions, outpatient attendances and hospital admissions. Healthcare costs will be compared with a non-exposed control group of acceptable, HES eligible patients matched in a 1:1 ratio on age, sex, registration status at the date of the case’s start of follow-up and general practice where appropriate. Quintiles of deprivation score (Practice Level Index of Multiple Deprivation) will be described. Incidence and point prevalence will be calculated on a yearly basis.
This study will provide valuable information on the healthcare burden associated with mental and behavioural disorders and help to inform healthcare decision-making.
Patient characteristics; Comorbidities; Healthcare resource use; Healthcare costs; All-cause mortality; Cause-specific mortality; Incidence; Prevalence
Craig Currie - Chief Investigator - Pharmatelligence Limited t/a Human Data Sciences
Sarah Holden - Corresponding Applicant - Pharmatelligence Limited t/a Human Data Sciences
Benjamin Heywood - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Bethan Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Chris Shepherd - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christian Bannister - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christopher Morgan - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Darren Summers - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Elgan Mathias - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Ellen Hubbuck - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
James Bateman - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Rhiannon Thomason - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Thomas Berni - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation