Prospectively identifying adults with serious mental illness at risk for poor physical health: The role of person reported outcomes

Abstract

Objective: Persons with serious mental illnesses are at increased risk for co-occurring physical comorbidities. Patient-reported outcome measures are increasingly used in routine assessments of persons with serious mental illnesses, yet the relation of patient-reported outcome measures to physical health outcomes has not been comprehensively investigated. We examined the association between patient-reported outcome measures and self-reported physical health at 1-year follow-up. Design: A retrospective cohort study. Setting: Data were collected as part of the Israeli Psychiatric Rehabilitation Patient-Reported Outcome Measurement program in Israel. Participants: A total of 2581 psychiatric rehabilitation service users assessed between April 2013 and January 2016. Main Outcome Measures: Self-reports on two consecutive years of physical health dichotomized as poor versus good. Results: More than one-third of participants reported having poor physical health. Multivariate regression analysis showed that quality of life (odds ratio [OR] = 0.71; 95% confidence interval [CI]: 0.60-0.84) and lack of effect of symptoms on functioning (OR = 0.81; 95%CI: 0.74-0.89) predict subsequent physical health, controlling for all other factors. Compared to a multivariate model with personal characteristics and self-reports on physical health at baseline (Model A), the model which also included patient-reported outcome measures (Model B) showed slightly better discrimination (c-statistic: 0.74 vs. 0.76, respectively). Conclusions: These results suggest that patient-reported outcome measures contribute to the prediction of poor physical health and thus can be useful as an early screening tool for people with serious mental illnesses living in the community, who are at risk of physical health problems.