MHRN Add-on Queries
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Query title
1
Exploration of Cancer + Mental Health
2
BMI measures in youth taking antipsychotics
3
How are antipsychotics being used?
4
Rates of untreated MH patients
5
QA of accidental, assault, adverse effect, and underdosing injury/poisoning code lists.
6
Update to Self-Injury and SI prevalence for children and adolescents
7
Mental Health Surveillance During the COVID era
8
Variation in demographic characteristics for youth with child maltreatment
9
Rates of self-harm in children
10
Suicide mortality trends during the COVID-19 pandemic
11
Use of clozapine in people with psychotic disorders
12
Poisonings (intentional and undetermined) by drug class categories in diagnosis codes
13
Virtual care in the VDW
14
Austism Service Use
15
ICD10 Injury/Poisoning/External Cause QA
16
Glucagon-like peptide 1 (GLP-1) agonists use among people with and without mental health conditions
17
Use of Clozapine among people with possible indication
18
Questions and Responses for selected PRO (patient reported outcomes)
19
SDoH diagnostic codes
20
Subdivide eating disorders
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Mental health diagnosis in members with new cancer diagnoses (ICD-10 diagnoses for both)

Mental health diagnosis in members with new cancer diagnoses (from tumor), by stage

How many patients have a pre-existing mental health diagnosis before their cancer diagnosis? How many receive a mental health diagnosis after their cancer diagnosis? How many patient with cancer have not mental health diagnosis?

Do we see differences in patient background or in survival between the patients with/without MH diagnosis pre/post cancer diagnosis?

7/2/2021
Done
Analyses using dx: all except BSW. Analyses using tumor: all except BSW, HPHC, KPSC, PAMF

Rates of mental health diagnoses are higher in patients with metastasized cancers compared to those with earlier stage cancers (33.5% vs 28.2%), particularly for anxiety and depressive disorders. This trend was observed when using cancer diagnosis by ICD-10 code and when using cancer stage at diagnosis from tumor registry data.

Ellis will convene discussion with MHRN members interested in further research on this topic to discuss potential next steps. Next steps may include a MHRN pilot project or other grant proposal.

Rob Penfold
robert.b.penfold@kp.org;
Todo
Rebecca Rossom
Rebecca.C.Rossom@HealthPartners.Com;

For what indications are antipsychotics being prescribed in our healthcare systems?

1/8/2020
Done
All but HPHC

Manuscript in preparation

Chris Lu
christine_lu@harvardpilgrim.org;

Examine the recent rate of patients with depression dx but not on drug treatments or receiving psychotherapy (2016 onwards)

1/27/2020
Done
All but KPSC, HPHC, HFHS, PAMF
Chris Stewart
Chris.C.Stewart@kp.org;

Are the rates of these newly-constructed code lists reasonable and consistent across sites?

12/31/2019
Done
ALL, HPHC dates shifted 6 mo earlier

QA Pass, accidental higher than self-inflicted, others very low as expected

.

Code lists were used in Zero Suicide Opioid Supplement, are ready to use in general where needed.

Rob Penfold
robert.b.penfold@kp.org;

How has the prevalence of self-injury and ideation changed between 2014 and 2020 with respect to ICD10 and COVID

6/24/2021
Done
All except KPSC and PAMF

Please enter a brief (1-2 sentence) description of what you plan to do with these results.

Brian Ahmedani
Rebecca Rossom
bahmeda1@hfhs.org;, Rebecca.C.Rossom@HealthPartners.Com;

Evaluate changes in documented mental health factors during COVID (Monthly rates of diagnosis, prescriptions, psychotherapy.

]

4/16/2020
Done
First round KPWA, KPNW, KPNC, KPHI, HPI, EIRH. Later, all but BSW and PAMF.

COVID supplement to MHRN proposed, awarded, in progress.

Frances Lynch
Sonya Negriff
frances.lynch@kpchr.org;, Sonya.X.Negriff@kp.org;

What are the demographic characteristics of youth identified as having experienced child maltreatment compared to those who have not. Are patterns the same across health systems?

3/24/2020
Done
ALL N=13

Diagnosis codes are insufficient for identifying this population

Identification of population by NLP Pilot in progress

Gregory Simon
Michael Schoenbaum
Jane Pearson
Gregory.E.Simon@kp.org;, schoenbaumm@mail.nih.gov;, jpearson@mail.nih.gov;

What are the network-wide rates and Ns of self harm in ages 0-4 and 5-11

4/6/2020
Done
All but BSW

<0.01% and 0.01%, respectively

None, not feasible to look at age/gender/race/ethnicity in these small numbers.

Gregory Simon
Gregory.E.Simon@kp.org;

Use preliminary data where available to look at very recent suicide death rates

12/2/2020
Done
KPWA, KPCO, HPI, HFHS (requirement for recent official death certificate data.)

Overall suicide mortality rates did not increase with the pandemic, and in fact slightly declined from March to December 2020.

Paper under review by Medical Care.

Gregory Simon
Gregory.E.Simon@kp.org;

Describe rates of use of clozapine in people with diagnoses of schizophrenia-spectrum disorders or schizoaffective disorder

1/14/2021
Done
Fulfilled by Rossom Jan 2020 data, including all sites except HPHC

Across MHRN health systems, only 3-4% of people with psychotic disorders are current or recent users of clozapine

More detailed analyses will examine clozapine use among people who appear to have a clear indication (e.g. recent hospitalization, recent self-harm).

Gregory Simon
Gregory.E.Simon@kp.org;

Describe how intentional and undetermined intent overdoses break down across medication classes.

2/9/2021
Done
All except BSW

"Other and unspecified" categories account for over 1/4 of self-harm overdoses. It is not possible to accurately estimate the proportion of self-harm overdoses that involve medications recently dispensed.

Different data will be required to estimate the potential impact of a safe medication dispensing (i.e. blister packaging) intervention

Chris Stewart
Chris.C.Stewart@kp.org;

How are virtual visits documented in the VDW? (by enctype and encounter_subtype)

4/1/2021
Done
All except KPGA, HFHS, BSW (not implemented)

Enctype = 'VC' with encounter_subtype = 'VV' or 'TS' represent virtual care replacing outpatient visits.

Use this as tentative definition of virtual visits - continue to monitor

Ashli Owen-Smith
aowensmith@gsu.edu;

How frequently are various ASD-related treatments being used in our healthcare systems?

1/24/2011
Done
All

Cummings JR, Lynch FL, Rust KC, et al. Health Services Utilization Among Children With and Without Autism Spectrum Disorders. J Autism Dev Disord. 2016;46(3):910-920. doi:10.1007/s10803-015-2634-z

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747787/

Gregory Simon
Susan Shortreed
Gregory.E.Simon@kp.org;, Susan.M.Shortreed@kp.org;

What proportion of injury (S) codes have an accompanying external cause where that code is not embedded.(by section).

Note: re-run of MHRN_SelfHarm_QA_V2 for 2016-2021.


1/3/2022
Done
All

Repeating with revised set of ICD-10 codes per Michael Schoenbaum, 5/2022. Revised manuscript under review as of 4/11/24.


Rebecca Rossom
Rebecca.C.Rossom@HealthPartners.Com;

How often are glucagon-like peptide 1 (GLP-1) agonists medications used by people with and without mental health conditions, and how does that vary by subgroup?

2/1/2022
Done
All
Gregory Simon
Gregory.E.Simon@kp.org;
5/4/2022
Done
BSW, EIRH, HPHC, HPI, HFHS, KPCO, KPGA, KPHI, KPNC, KPNW, KPSC, KPWA, PAMF/Sutter

Among patients experiencing a self-harm event and patients with significant suicidal ideation, only 3% had any prior clozapine use and only 1% initiated clozapine during the following 12 months.  Among patients with hospitalization or ED visit despite pharmacotherapy, 9% had any prior clozapine treatment, and 3% initiated clozapine over 12 months. Among those with significant suicidal ideation, rates of both prior clozapine treatment and subsequent initiation varied significantly by race and ethnicity, with rates among Hispanic and Non-Hispanic Black patients lower than among Non-Hispanic Whites.

Paper in press at J Clin Psych

Chris Stewart
Chris.C.Stewart@kp.org;

What are the questions (map ID to item on a scale) and answers in the PRO data, starting with CSSRS and SDOH PROs

12/14/2022
Done
KPWA, KPNC, KPNW, KPSC, KPCO, KPGA

Mapping of question_ids to items completed for GAD, AUDIT, PHQ, Columbia.

Survey of SDOH measures (only KP has in PRO tables), rates of completion where possible. Documentation in G:/...Workgroup_VDW/MHRN3quarterly/2022-04

Mapping to be used in multi-site programs. SDOH - will continue to see if administrations grow. Can map SRQ items, may want new query to count people with different types of needs, or those desiring help. Can use existing SDOH pros as covariates but need to understand the demographics of who receives these questions.

Elyse Llamocca
ellamoc1@hfhs.org;

What are the rates of recording in people with and without other MH diagnoses.

Done
KPWA, KPNW, KPSC, KPHI, KPCO, KPGA

Manuscript under review.

Frances Lynch
frances.lynch@kpchr.org;

Routine quarterly analyses show a significant increase in diagnoses of eating disorder diagnoses since 2019. Does that increase occur across all of the types of eating disorders?

3/15/2023
In progress
20 records

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