Validation study of the population included in the Danish Schizophrenia Registry.

INTRODUCTION: We aimed to assess the validity of the schizophrenia diagnoses registered in the Danish Schizophrenia Registry (DSR) by comparing with information from medical records. METHODS: The study included a random sample of 390 subjects from the DSR who were representative of each geographic region of Denmark. For each subject in the sample, a medical record review was performed by local psychiatrists to confirm or disconfirm the schizophrenia diagnosis and to give a qualified estimate of the date of diagnosis. Only register data and medical record information were used, and thus the individuals in the sample were not approached. We calculated the positive predictive value, comparing registrations in the DSR with the original medical records as a reference. RESULTS: A total of 325 out of 390 (83%) medical records were reviewed. The positive predictive value was 91% (95% confidence interval (CI): 88-94%), varying between geographic regions from 85% to 100%. The classification of incident versus prevalent disease corresponded with the reference in 93% (95% CI: 80-97%) of cases diagnosed in 2014-2015. CONCLUSIONS: The DSR includes the intended patient population and represents a valid and valuable source for improving quality of care and for research. FUNDING: The study was financed by the Danish Regional Development Fund for Clinical Quality. TRIAL REGISTRATION: not relevant.

The Danish Schizophrenia Registry.

AIM OF DATABASE: To systematically monitor and improve the quality of treatment and care of patients with schizophrenia in Denmark. In addition, the database is accessible as a resource for research. STUDY POPULATION: Patients diagnosed with schizophrenia and receiving mental health care in psychiatric hospitals or outpatient clinics. During the first year after the diagnosis, patients are classified as incident patients, and after this period as prevalent patients. MAIN VARIABLES: The registry currently contains 21 clinical quality measures in relation to the following domains: diagnostic evaluation, antipsychotic treatment including adverse reactions, cardiovascular risk factors including laboratory values, family intervention, psychoeducation, postdischarge mental health care, assessment of suicide risk in relation to discharge, and assessment of global functioning. DESCRIPTIVE DATA: The recorded data are available electronically for the reporting clinicians and responsible administrative personnel, and they are updated monthly. The registry publishes the national and regional results of all included quality measures in the annual audit reports. External researchers may obtain access to the data for use in specific research projects by applying to the steering committee. CONCLUSION: The Danish Schizophrenia Registry represents a valuable source of informative data to monitor and improve the quality of care of patients with schizophrenia in Denmark. However, continuous resources and time devoted is necessary to maintain the integrity of the registry and the validity of the data.

Improving quality of care among patients hospitalised with schizophrenia: a nationwide initiative.

BACKGROUND: The effectiveness of systematic quality improvement initiatives in psychiatric care remains unclear. AIMS: To examine whether quality of care has changed following implementation of a systematic monitoring programme of hospital performance measures. METHOD: In a nationwide population-based cohort study, we identified 14 228 patients admitted to psychiatric departments between 2004 and 2011 from The Danish Schizophrenia Registry. The registry systematically monitors the adherence to guideline recommended processes of care. RESULTS: The overall proportion of all relevant recommended processes of care increased from 64 to 76% between 2004 and 2011. The adherence to individual processes of care increased over time, including assessment of psychopathology using a diagnostic interview (relative risk (RR): 2.01, 95% CI: 1.51-2.68), contact with relatives (RR: 1.44, 95% CI: 1.27-1.62), psychoeducation (RR: 1.33, 95% CI: 1.19-1.48), psychiatric aftercare (RR: 1.06, 95% CI: 1.01-1.11) and suicide risk assessment (RR: 1.31, 95% CI: 1.21-1.42). CONCLUSIONS: Quality of care improved from 2004 to 2011 among patients hospitalised with schizophrenia in Denmark. DECLARATION OF INTEREST: None. COPYRIGHT AND USAGE: © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.