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Hardcastle, K, Bellis, MA, Sharp, CA and Hughes, K (2020) 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, 10 (9). ISSN 2044-6055
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Exploring the health and service utilisation of general practice patients with a history of adverse childhood experiences (A.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. Download (478kB) | Preview |
Abstract
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.
| Item Type: | Article |
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| Uncontrolled Keywords: | Humans; Cross-Sectional Studies; Child Abuse; Child; Infant; England; Wales; Electronic Health Records; General Practice; Adverse Childhood Experiences; adverse events; mental health; primary care; public health; Adverse Childhood Experiences; Child; Child Abuse; Cross-Sectional Studies; Electronic Health Records; England; General Practice; Humans; Infant; Wales; 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences |
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Public Health Institute |
| Publisher: | BMJ |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 21 Dec 2022 10:40 |
| Last Modified: | 21 Dec 2022 10:40 |
| DOI or ID number: | 10.1136/bmjopen-2019-036239 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/18460 |
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