{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:02:22Z","timestamp":1785315742265,"version":"3.55.0"},"reference-count":29,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec id=\"S0007125025000492_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Physical health checks in primary care for people with severe mental illness ((SMI) defined as schizophrenia, bipolar disorders and non-organic psychosis) aim to reduce health inequalities. Patients who decline or are deemed unsuitable for screening are removed from the denominator used to calculate incentivisation, termed exception reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000492_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the prevalence of, and patient characteristics associated with,\u00a0exception reporting in patients with SMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000492_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We identified adult patients with SMI from the UK Clinical Practice Research Datalink (CPRD), registered with a general practice between 2004 and 2018. We calculated the annual prevalence of exception reporting and investigated patient characteristics associated with exception reporting, using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000492_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 193\u00a0850 patients with SMI, 27.7% were exception reported from physical health checks at least once. Exception reporting owing to non-response or declining screening increased over the study period. Patients of Asian or Black ethnicity (Asian: odds ratio 0.72, 95% CI 0.65\u20130.80; Black: odds ratio 0.86, 95% CI 0.76\u20130.97; compared with White) and women (odds ratio 0.90, 95% CI 0.88\u20130.92) had a reduced odds of being exception reported, whereas patients diagnosed with \u2018other psychoses\u2019 (odds ratio 1.19, 95% CI 1.15\u20131.23; compared with bipolar disorder) had increased odds. Younger patients and those diagnosed with schizophrenia were more likely to be exception reported owing to informed dissent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025000492_as5\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exception reporting was common in people with SMI. Interventions are required to improve accessibility and uptake of physical health checks to improve physical health in people with SMI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.49","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T07:28:50Z","timestamp":1747380530000},"page":"340-347","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of people with severe mental illness excluded from incentivised physical health checks in the UK: electronic healthcare record study"],"prefix":"10.1192","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4241-938X","authenticated-orcid":false,"given":"Naomi","family":"Launders","sequence":"first","affiliation":[{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2067-2811","authenticated-orcid":false,"given":"Caroline A.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-3862","authenticated-orcid":false,"given":"Joseph F.","family":"Hayes","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"Camden and Islington NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5657-6995","authenticated-orcid":false,"given":"Ann","family":"John","sequence":"additional","affiliation":[{"name":"Swansea University Medical School, Swansea University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4435-6397","authenticated-orcid":false,"given":"Robert","family":"Stewart","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London"},{"name":"South London and Maudsley NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7242-0456","authenticated-orcid":false,"given":"Matthew H.","family":"Iveson","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences, University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1369-5983","authenticated-orcid":false,"given":"Elvira","family":"Bramon","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"Camden and Islington NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4191-4880","authenticated-orcid":false,"given":"Bruce","family":"Guthrie","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1703-3664","authenticated-orcid":false,"given":"Stewart W.","family":"Mercer","sequence":"additional","affiliation":[{"name":"Usher Institute, University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1539","authenticated-orcid":false,"given":"David P.J.","family":"Osborn","sequence":"additional","affiliation":[{"name":"University College London"},{"name":"Camden and Islington NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"S0007125025000492_ref3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230674"},{"key":"S0007125025000492_ref29","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2024-002732"},{"key":"S0007125025000492_ref1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003976"},{"key":"S0007125025000492_ref6","unstructured":"6 National Health Service (NHS)\u00a0Digital. 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Ethnic Group Classifications: Census 2021. ONS, 2023 (https:\/\/www.ons.gov.uk\/census\/census2021dictionary\/variablesbytopic\/ethnicgroupnationalidentitylanguageandreligionvariablescensus2021\/ethnicgroup\/classifications)."},{"key":"S0007125025000492_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16151"},{"key":"S0007125025000492_ref15","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5318"},{"key":"S0007125025000492_ref17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001885"},{"key":"S0007125025000492_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2022.107274"},{"key":"S0007125025000492_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042497"},{"key":"S0007125025000492_ref22","unstructured":"22 National Health Service (NHS) England. Improving the Physical Health of People Living with Severe Mental Illness. NHS England, 2024 (https:\/\/www.england.nhs.uk\/long-read\/improving-the-physical-health-of-people-living-with-severe-mental-illness\/)."},{"key":"S0007125025000492_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006135"},{"key":"S0007125025000492_ref28","unstructured":"28 National Health Service (NHS) Digital. Quality and Outcomes Framework, 2020\u201321: Technical Annex. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}