Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records
Objectives To examine the relationships between adverse childhood experiences (ACEs), chronic health and health service utilisation among a sample of general practice patients.Design Cross-sectional observational study using anonymised data from electronic health records for 763 patients.Setting Fou...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e036239.full |
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| author | Mark A Bellis Karen Hughes Katie Hardcastle Catherine A Sharp |
| author_facet | Mark A Bellis Karen Hughes Katie Hardcastle Catherine A Sharp |
| author_sort | Mark A Bellis |
| collection | DOAJ |
| description | Objectives To examine the relationships between adverse childhood experiences (ACEs), chronic health and health service utilisation among a sample of general practice patients.Design Cross-sectional observational study using anonymised data from electronic health records for 763 patients.Setting Four general practices in northwest England and North Wales.Outcome measures Patient demographic data (age, gender); body mass index; self-reported smoking status; self-reported ACEs; diagnosis of chronic health conditions; current mental health problems; total number of service contacts and repeat medication use in the previous 6 months.Results A history of ACEs (experiencing abuse or neglect as a child, and/or growing up in a household characterised by violence, substance use, mental health problems or criminal behaviour) was strongly independently associated with current mental health problems, smoking and chronic obstructive pulmonary disease, showing a dose–response relationship with level of ACE exposure. Medication use and contact were significantly greater among patients with high ACE exposure (≥4 ACEs), compared with those with no ACEs. However, contrary to findings from population studies, health service utilisation was not significantly different for patients with increased ACE exposure (1–3 ACEs) and their ACE-free counterparts.Conclusions Findings highlight the contribution ACEs make to unequal distributions of risk to health and well-being and patterns of health service use in the UK. |
| format | Article |
| id | doaj-art-ab04afcee2ab4de5951119537ccc749f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-ab04afcee2ab4de5951119537ccc749f2025-01-09T04:00:14ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-036239Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health recordsMark A Bellis0Karen Hughes1Katie Hardcastle2Catherine A Sharp3Liverpool John Moores University, Liverpool, UK1Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health WalesWHO Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UKPublic Health Collaborating Unit, BIHMR, College of Human Sciences, Bangor University, Bangor, Gwynedd, UKObjectives To examine the relationships between adverse childhood experiences (ACEs), chronic health and health service utilisation among a sample of general practice patients.Design Cross-sectional observational study using anonymised data from electronic health records for 763 patients.Setting Four general practices in northwest England and North Wales.Outcome measures Patient demographic data (age, gender); body mass index; self-reported smoking status; self-reported ACEs; diagnosis of chronic health conditions; current mental health problems; total number of service contacts and repeat medication use in the previous 6 months.Results A history of ACEs (experiencing abuse or neglect as a child, and/or growing up in a household characterised by violence, substance use, mental health problems or criminal behaviour) was strongly independently associated with current mental health problems, smoking and chronic obstructive pulmonary disease, showing a dose–response relationship with level of ACE exposure. Medication use and contact were significantly greater among patients with high ACE exposure (≥4 ACEs), compared with those with no ACEs. However, contrary to findings from population studies, health service utilisation was not significantly different for patients with increased ACE exposure (1–3 ACEs) and their ACE-free counterparts.Conclusions Findings highlight the contribution ACEs make to unequal distributions of risk to health and well-being and patterns of health service use in the UK.https://bmjopen.bmj.com/content/10/9/e036239.full |
| spellingShingle | Mark A Bellis Karen Hughes Katie Hardcastle Catherine A Sharp Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records BMJ Open |
| title | Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records |
| title_full | Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records |
| title_fullStr | Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records |
| title_full_unstemmed | Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records |
| title_short | Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (ACEs): an observational study using electronic health records |
| title_sort | exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences aces an observational study using electronic health records |
| url | https://bmjopen.bmj.com/content/10/9/e036239.full |
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