Saudi Cultural Missions Theses & Dissertations
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Item Restricted Orthodontic Treatment and Psychosocial Well-being in Young People: A Scoping Review(Saudi Digital Library, 2024) AlZaher, Rabab H; Mishu, MasumaBackground: Adolescence and young adulthood (10–24 years) are critical periods of identity formation, during which dental appearance can significantly affect self-esteem, emotional well- being, and social functioning. While orthodontic treatment is often pursued for functional or aesthetic reasons, emerging evidence suggests potential mental health benefits. Aim: This scoping review explored the association between orthodontic treatment and psychosocial outcomes in young people, including self-esteem, emotional well-being, and social functioning. Methods: A comprehensive literature search was conducted across three databases, following the Arksey and O’Malley framework and PRISMA-ScR guidelines. Empirical studies in English examining the psychosocial effects of orthodontic treatment in individuals aged 10–24 were included. Fourteen studies (cross-sectional, longitudinal, and one interventional) met the criteria. Results: The included studies reported improvements in self-esteem, emotional well-being, and social functioning, often measured with validated tools such as the PIDAQ, CPQ, and Rosenberg Self-Esteem Scale. Qualitative findings further highlighted perceived gains in confidence and social acceptance. Nonetheless, some studies reported mixed or null effects, suggesting variability depending on individual factors such as baseline self-perception, treatment expectations, or exposure to bullying. Overall, the evidence indicates that orthodontic treatment may provide meaningful psychosocial benefits, though these are not uniformly experienced. Conclusion: Orthodontic treatment may offer psychosocial benefits for young people, though the evidence base is methodologically fragmented. Future research should use standardised, theory-informed tools and longer follow-ups. Clinicians should incorporate psychosocial considerations into adolescent-centered care.16 0Item Restricted The Role of Natural Language Processing in Early Detection of Mental Health Conditions from Social Media Data(Saudi Digital Library, 2025) Alasery, Aidh; Lauria, StashaMental health disorders such as anxiety, depression, and schizophrenia are increasing rapidly and affect a significant proportion of the global population. As a result, the affected patients suffer negative consequences such as high financial costs of treatment and a poor quality of life. The reliance on traditional clinical methods to diagnose mental health problems further leads to delays in identifying the disorders among affected individuals. An emerging approach to address the delay is the adoption of artificial intelligence (AI) through natural language processing (NLP) models, which can evaluate real-time social media content to identify individuals at risk of mental health problems. The current research sought to identify how NLP techniques could be adopted for the early diagnosis and detection of mental health illnesses from social media interactions. Data was collected using the scoping review method, where 20 qualitative peer reviewed journal articles were identified and assessed. To evaluate the findings obtained in the study, thematic analysis was adopted. The generated insights indicated that using deep learning techniques, including recurrent neural networks (RNNs) and classification machine learning methods, such as decision trees (DT), facilitated the detection of mental health illnesses. Further insights revealed that techniques such as data anonymisation were effective for privacy preservation, and explainable AI (XAI) were useful in upholding the privacy of user data during the data collection phase. Additionally, various advantages of NLP models were elaborated, including accuracy, generalisability, and fairness. However, challenges such as risks of bias and breaching the privacy of user data were also identified. In future work, there is a need to investigate how the NLP models can be enhanced further by integrating more technologies, such as big data.34 0Item Restricted Developing a pharmaceutical care screening tool for use by acute mental health clinical pharmacy services(Saudi Digital Library, 2025) Alshaikhmubarak, Fatima Qais; Lewis, Penny J; Keers, Richard NBackground: Mental health inpatient pharmacy teams in the UK are under pressure to deliver optimal care despite limited resources and staff shortages. Prioritising clinical pharmacy services is an innovative approach that aims to optimise the use of pharmacy expertise and reduce the incidence of Drug Related Problems (DRPs). Patient prioritisation tools have been developed and shown to be effective in improving patient outcomes and service delivery in acute care. Such approaches are much needed in mental health hospitals where medications are the main therapeutic intervention and patients are highly vulnerable to DRPs due to factors such as cognitive impairment. Research aim: The aim of this research programme was to develop a pharmaceutical care screening tool for use by acute mental health clinical pharmacy services. Methods: A systematic review was undertaken to identify risk factors for DRPs in hospital based mental health units. This was followed by a multi-method study where all mental health NHS trusts and boards in the UK were surveyed to identify organisations using pharmaceutical patient prioritisation approaches. Identified organisations were invited for follow up interviews and to provide their prioritisation documents for analysis. The third step towards the tool development was two sequential Delphi questionnaires, informed by the systematic review and the multi-method study, aiming to reach agreement on the content and design of the tool. Lastly, iterative acceptability testing was undertaken where mental health pharmacy team members from five NHS organisations tested the developed tool and provided feedback through reflection sheets and focus group discussions. Qualitative data was analysed thematically using NVivo software and quantitative data was summarised using Microsoft Excel. Results: A total of 22 studies were included in the systematic review. Identified risk factors included increased number of prescribed medications, advanced age and length of hospitalisation. The multi-method study identified 21 (n=21/55, 38.2%) organisations using patient prioritisation systems. A total of 15 interviews were conducted and 11 prioritisation documents were received. Identified systems varied greatly in their development, use, and complexity. A total of 36 experts completed the first round of Delphi study one (agreement reached on inclusion of 43.1% (47/109) of the risk indicators) and 29 completed the second round (agreement reached on inclusion of 66.7% (82/123) of the risk indicators). Experts agreed on using the traffic light system (red, amber, and green) to classify patients into risk groups. For Delphi study two, 32 experts completed the first round (agreement reached on inclusion of 41.3% of statements) and 30 completed the second round (agreement reached on inclusion of 44.8% of statements). The developed tool was generally acceptable by pharmacy professionals from five NHS organisations and participants’ feedback helped refine it further. Conclusion: This PhD programme developed an evidence- and consensus- based patient prioritisation tool accompanied by a manual and training material for mental health pharmacy teams. This tool may enhance clinical decision-making and help achieve the shared objectives of the mental health outcomes strategy “No Health Without Mental Health”. Future work may help further explore the tool’s feasibility and effectiveness and assist in determining its usability and future potential across diverse contexts.11 0Item Restricted Impact of interprofessional collaboration between midwives, nurses and mental health professionals in the care of mothers with postpartum depression and psychosis in the United Kingdom(Saudi Digital Library, 2025) Alsafwani, Zahra; Lees, CarolynAbstract Background: Postpartum depression (PPD) affects 23.9% of mothers in England and postpartum psychosis (PP) has an incidence of 0.25-0.6 cases per 1000 UK births, contributing to suicide as the leading cause of maternal mortality in high-income countries and costing the NHS nearly £8.1 billion annually. Despite initiatives such as the creation of community perinatal teams from 2019 and NHS recommendations, systemic barriers persist including the operational disconnect between primary care and mental health, the uneven distribution of Mother-Baby Units (MBUs), training deficits, with 68% of GPs acknowledging a lack of training in postnatal mental health and the underutilisation of validated tools such as the Edinburgh Scale (EPDS). Aims: This narrative review aimed to examine the impact of interprofessional collaboration between midwives, nurses and mental health specialists on the quality of care for mothers with PPD and PP in the UK, assessing its influence on access to specialist treatment, clinical outcomes and structural barriers limiting its effectiveness. Method: Following the PRISMA protocol, a systematic search was conducted in PubMed, Scopus and Medline for the period 2016-2024 using Boolean operators combining ‘postpartum depression’ or ‘postpartum psychosis’ with ‘midwives’ or ‘nurses’ and ’ collaboration ’ or ‘teamwork’ in the UK context. Result: 371 initial records were obtained, after removing duplicates and applying inclusion criteria, 42 articles were assessed using the CASP list and 8 studies were included for analysis in this review. Conclusion: Interprofessional collaboration is essential to optimise the early detection and treatment of PPD and PP, but it requires concrete actions to overcome the fragmentation of the healthcare system. The importance of establishing clinical liaison roles to ensure continuity after postpartum is highlighted. Implement practical training programmes on perinatal mental health for professionals through simulations. At the same time, there must be a firm stance on investment in equitable coverage of MBU units. These reforms, designed in collaboration with patients and professionals, are essential to improving perinatal care. And thus, address the more than £8.1 billion per year that perinatal mental health problems generate for the NHS.36 0Item Restricted What are the most effective public health strategies for promoting mental health and reducing the cardiovascular burden associated with depression?(Saudi Digital Library, 2025) Alsoghyar, Nawaf; Verma, ArpanaABSTRACT Background Depression is a significant contributor to the global disease burden and is strongly associated with increased cardiovascular mortality and morbidity. Mental health disorders, particularly Depression, influence biological processes such as health behaviours and inflammation. Autonomic dysfunction results in adverse cardiovascular outcomes. Public health strategies focused on addressing mental health could concurrently reduce the burden of cardiovascular diseases. However, identifying the most effective strategy requires a systematic and critical review approach. Methods A critical literature review employs the PICOS (Population, Intervention, Comparator, Outcome, Study design) framework. Databases such as Medline, Scopus, PsycInfo, and Web of Science were searched using keywords and medical subject headings related to depression, cardiovascular disease, mental health promotion, and public health strategies. Inclusion criteria comprised peer-reviewed articles published between 2010 and 2024, concentrating on adult populations and studies reporting cardiovascular and mental health outcomes and interventions at the population or community level. Exclusion criteria eliminated studies focusing solely on pharmacological interventions or those lacking a cardiovascular component. Results The review found seven studies that met the inclusion criteria. Major interventions included psychological therapies based on community, lifestyle modification initiatives, workplace Programs for mental wellness, physical activities, and policy-driven campaigns that address social determinants of health. Multifaceted interventions incorporating psychological support with managing cardiovascular risk depicted the most significant improvement in mental wellbeing and reduction of cardiovascular markers such as BMI, blood pressure, and inflammation. School and workplace-based programs depicted positive long-term change in behaviour, specifically when culturally adapted. However, disparities in accessibility, sustainability, and responsiveness towards give remain challenges across many low- and middle-income countries. Conclusion Practical strategies for public health that promote mental health and reduce the multi-tiered cardiovascular burden should target individual and structural interventions. Programs that combine mental health promotion with cardiovascular health education and behavioural change interventions, especially those driven by community and context-specific factors, tend to yield the most impactful results. Future research should address gaps in culturally inclusive models with sustainable delivery systems.19 0Item Restricted An Exploration of Occupational Therapists’ Understanding of Mental Health in Saudi Arabia: A Qualitative Investigation.(Saudi Digital Library, 2025-03-03) Alrashidi, Raiyad Abbad D Alrashidi; Whitcombe, SteveObjectives: This study explores the understanding of mental health among occupational therapists in Saudi Arabia. The objectives of the research were to examine the professional and cultural factors that influence occupational therapists’ perceptions of mental health, to assess opportunities and challenges faced by occupational therapists working in mental health settings and to explore the perceived value and role of occupational therapy in mental health care in Saudi Arabia. Methodology: This study used an exploratory- descriptive qualitative approach. Data was collected through semi-structured interviews from eight occupational therapists practising in Saudi Arabia. The data was analysed using reflexive thematic analysis, a framework that facilitated identification and development of key themes. Findings: The findings were categorised into four main themes. Firstly, occupational therapists’ perceptions of mental health. The study revealed varying levels of understanding and awareness of mental health which attributed to lack of professional training in this area. Secondly, inadequacies in training and education showed the need for improved professional development opportunities in mental health among occupational therapists in Saudi Arabia. The third theme examined current challenges and cultural influences in that occupational therapists in Saudi Arabia face systematic barriers since there are no policies to support their role in mental health. They are challenges related to stigma surrounding mental health and limited collaboration between OTs and other healthcare professionals. The final theme centred on future perspectives and recommendations, where participants advocated for increased awareness of their role - occupational therapy in mental health situations. There is a need for policy reforms and integration of occupational therapy into mental health services through professional training. Conclusion: This study provides information on whether mental health has been integrated into occupational therapy in Saudi Arabia and examines the opportunities and challenges facing OT professionals working in the mental health field. The study highlights the importance of addressing challenges such as cultural and systematic barriers limiting the integration of metal health in OT and a need to enhance education opportunities promoting the role of occupational therapy in mental health. The findings of this study will inform future policies and research that will support the integration of mental health into occupational therapy.34 0Item Restricted Navigating Male Partner Infertility Through a Bowen Family Systems Theory Lens: An In-depth Analysis of Women’s Experience and Psychological Interventions(Nova Southeastern University, 2025) Khalil, Dania; Venetia, Bennett; Tracey-Ann, SpencerMale infertility can be disturbing to individuals in a relationship system where the reproduction of children is one of the agreed upon goals of the relationship. This life crisis can cause severe emotional and psychological distress for the female partner within the relationship system. Additionally, social pressure, and other effects outside of the relationship system may be experienced and cause further distress to these women. This ACP critically analyzed the literature on the emotional experience of females whose male partner is struggling with infertility, their mental health, treatment journey, relational concerns, and coping strategies utilized by those women to manage the stress associated with such a condition. The review identified several gaps, notably the limited research on the emotional experience of women whose partner was diagnosed with infertility. Additionally, limited research surrounds the implementation of psychotherapeutic interventions that could help the targeted population. In response to these gaps, this project will conduct a critical analysis of the literature utilizing Bowen family system theory (BFST) to make sense of the women's experiences. In addition, it will incorporate BFST in the development of a psychotherapeutic intervention for clinicians that will assist in improving women's capacity to manage stress linked to their male partner's infertility and address the inadequacies. The intervention proposed will help increase women's level of differentiation, enabling them to make rational responses as they interact with their spouses as well as the larger system.28 0Item Restricted Mindfulness as a Culturally Sensitive Moderator Between Stress and Anxiety in Saudi Female International Students(University of Cincinnati, 2024) Aldosari, Hend Abdullah; Brubaker, MichaelInternational students studying in the U.S. are becoming increasingly more common as students take advantage of new and existing educational opportunities. One of the larger populations of international students in the U.S. are Saudi students. While students face a number of stressors and anxieties related to schooling, Saudi international students face additional stressors related to adapting and acclimating to the new cultural environment. This is especially exacerbated in Saudi women, as they face discrimination based on the way they dress and have additional burdens such as family and childcare. However, culturally sensitive counseling approaches which address this unique population have yet to be fully investigated or developed. Mindfulness is a technique which involves quieting one’s mind and body and reflecting on one’s situation and circumstances without self-judgment. This approach has been used extensively as a technique to reduce and moderate the relationship between stress and anxiety generally and has been found to be effective in international students as well. Furthermore, mindfulness intersects directly with the principles of Islam through its focus on self-reflection and calming one’s mind, making it a culturally sensitive approach for Muslim clients, such as Saudi women. However, the moderating effects of mindfulness on stress and anxiety in Saudi female international students has yet to be investigated. The goal of this dissertation is to review what is known on the effects of mindfulness on stress and anxiety in international students and to investigate the moderating effects of mindfulness on stress and anxiety in Saudi female students in the U.S.21 0Item Restricted Mental Illness in Relation to Cardiovascular Disease Mortality and Out-of-Hospital Cardiac Arrest Characteristics and Survival(University of Edinburgh, 2024) Alotaibi, Raied; Jackson, CarolineAbstract Background People with mental illnesses have a 10–20 years shorter life expectancy than the general population. This mortality gap is primarily attributed to the increased risk and worse outcome of cardiovascular disease (CVD) among individuals with mental illnesses. Socioeconomic factors and healthcare accessibility, combined with systemic deficiencies in healthcare infrastructure and new policies aimed at reducing healthcare utilisation, may have exacerbated these disparities. Despite efforts to prioritise equitable care delivery, stigma and a lack of training among healthcare providers about mental health conditions persist, contributing to the ongoing challenges of addressing this issue. Although the link between mental illnesses and CVD is well established, the relationship between mental illnesses and out-of-hospital cardiac arrest (OHCA) characteristics and outcomes has been comparatively underresearched. The majority of OHCAs have an underlying cardiac aetiology, and hence, risk factors for CVD, such as depression, can influence the probability of experiencing OHCA and surviving it. A better understanding of how mental illnesses affect OHCA outcomes may help explain part of the overall observed lower life expectancy in patients with mental illnesses. Therefore, this thesis aims to explore the mortality gap between individuals with and without mental illnesses, with a specific focus on OHCA as a potential contributor to this gap. Methods In this thesis, I conducted a systematic literature review and three data analysis projects using different datasets and methods. In the first research project, I used data from the Scottish Mental Health Inpatient and Day Case Scottish Morbidity Record dataset to identify individuals who were 18 years of age or older and admitted with depression, as coded by the International Classification of Diseases (ICD)-10 F32– F33, between 2000 and 2019. I subsequently linked this dataset with death records to ascertain the causes of death. To estimate standardised mortality ratios (SMRs), I calculated the person-time at risk for people with severe depression by sex, 5-year age group, and calendar-year group. I estimated SMRs among individuals with severe depression using the whole Scottish population as the standard. To identify gaps in the current research on the relationship between mental illnesses and OHCA, I conducted a systematic review search of studies that looked into this topic, starting from the inception of relevant databases and ending on December 11, 2021, with an update on February 9, 2024. The search objective was to identify observational studies reporting on OHCA incidence, characteristics, or outcomes among individuals with mental illnesses. I and a second reviewer (another PhD student) independently screened titles and abstracts for eligibility. Both reviewers then independently assessed the full texts of potentially eligible articles against the eligibility criteria and independently conducted the data extraction. Following these initial investigations, I conducted two retrospective cohort studies using OHCA event data to further explore the survival and characteristics of OHCA in individuals with depression in one study and with unscheduled hospital admissions where a mental illness was recorded in the other study. In the first study, I used data from the ARREST (Amsterdam Resuscitation Studies) registry, spanning the period from 2008 to 2018. I extracted relevant comorbidity information, including depression, from patients' general practitioner records. OHCA survival was defined as survival 30 days after the OHCA or hospital discharge. To estimate the association between history of depression and OHCA survival, I used logistic regression modelling. Additionally, I explored the mediating effects of initial heart rhythm and bystander cardiopulmonary resuscitation (bCPR) provision. In the second study, I linked the Scottish Ambulance Services (SAS) OHCA dataset with the Unscheduled Care Data Mart (UCD). The UCD includes patient demographics, mortality data, emergency and urgent care service use across Scotland, and unscheduled hospital admission records to acute and psychiatric hospitals from January 1, 2011 onward. The analysis excluded individuals below 18 years of age, those with traumatic OHCA incidents, and those without community health index numbers. I classified exposed patients based on whether they had a documented history of an unscheduled hospital admission where a mental health illness was recorded (ICD-10 codes F00–F99) or had previously experienced unscheduled psychiatric hospital admissions before the OHCA event. I assessed the association between unscheduled hospital admission record of mental illness and 30-day survival following OHCA using both unadjusted and adjusted logistic regression models. I performed subgroup analyses to examine this association across some demographic and clinical strata, including age groups, sex, socioeconomic status, year of arrest, and prevalent types of mental illnesses in the study population. Results In the initial study, I found that among 28,808 individuals with severe depression, 27.4% died over a median follow-up of 8.7 years, with all-cause relative mortality being over three times higher than expected. Circulatory diseases were the leading causes of death, with excess mortality particularly pronounced for cerebrovascular disease. Both males and females with severe depression experienced higher all -cause and cause-specific mortality compared to the general population, with deaths from suicide having the highest SMR. For the literature review, the full search yielded 11,380 studies, with 10 meeting inclusion criteria (eight retrospective cohort studies and two nested case-control studies). Three of the included studies focused on depression, while seven encompassed various psychiatric conditions. People with mental illnesses were more likely to have arrests in private residences, unwitnessed arrests, more comorbidities, less bCPR, and non-shockable initial heart rhythms. The few studies that were identified also reported a higher OHCA incidence risk and lower survival rates in people with mental illnesses compared to people without mental illnesses. The analysis of the ARREST dataset included 5,594 OHCA cases, of which 582 individuals had pre-existing depression. These patients exhibited less favourable patient and resuscitation characteristics and lower odds of survival, even after adjusting for age, sex, and comorbidities. Initial heart rhythm and bCPR partially mediated the observed association, but they did not fully account for it. The final study, which used national Scottish data, initially identified 36,775 OHCA patients that were attended by SAS. After excluding those who were not eligible, the study included 30,523 patients with OHCA. Among the included cases, 12.8% had a history of an unscheduled hospital admission where a mental health illness was recorded. Those with a record of a mental illness had substantially lower 30-day survival odds compared to those without. This association persisted across various demographic and clinical subgroups. Conclusion This thesis addresses shortcomings in our understanding of the mortality gap between individuals with and without mental illnesses, particularly focussing on OHCA as a contributing factor. The findings show that patients with depression have higher mortality rates, mainly due to circulatory diseases. A systematic review highlighted the scarcity of research on OHCA among people with mental illnesses. Subsequent studies showed that patients with depression in the Netherlands and those with an unscheduled hospital admission record of mental illness in Scotland had lower OHCA survival rates, regardless of event characteristics or comorbidities. This thesis also discusses common barriers to pre-hospital and mental health research, emphasising the necessity for improved data linkage and comprehensive national datasets. The association between mental illness and lower OHCA survival persisted after adjusting for key OHCA characteristics that could potentially explain the link, suggesting that this association may be independent of these factors. Future research should further investigate the underlying mechanisms to help reduce premature mortality in people with mental illness, including factors not discussed in this thesis, such as the potential impact of psychotropic medications on OHCA incidence and outcomes.13 0Item Restricted Heart disease, health outcomes, and healthcare utilisation among middle-aged and older Australians: a longitudinal study using HILDA survey data(The University of Queensland, 2024) Alkalabi, Meshal; Keramat, Syed AfrozSTUDY 1 ABSTRACT Background Heart disease is a major public health concern globally, with substantial impacts on health outcomes among middle-aged and older adults. Understanding its influence on general health, mental health, self-assessed health, and health satisfaction is crucial for developing effective interventions tailored to this demographic in Australia. The study aims to investigate the longitudinal burden of heart disease on self-reported health outcomes among middle-aged and older Australians, focusing on general health, mental health, self-assessed health, and health satisfaction. Methods This study utilised longitudinal data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, focusing on individuals aged 40 years and older across four survey waves: 2009, 2013, 2017, and 2021. The study included 12,751 participants aged 40 and older, with 32,931 observations. Fixed-effects Generalised Least Squares (GLS) and fixed-effects ordered logistic regression models were applied to assess the association between heart disease and four health outcomes. Robustness checks were conducted using Generalised Estimating Equations (GEE) and random-effect GLS models. The analysis adjusted for sociodemographic, behavioural, and healthrelated variables. Results The results suggest that heart disease was negatively associated with general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. Specifically, participants with heart disease scored lower on general health (β = -4.67, 95% CI: -5.56 to -3.77, p < 0.001), mental health (β = -0.98, 95% CI: -1.84 to -0.12, p = 0.025), self-assessed health (β = -0.76, 95% CI: -0.94 to -0.58, p < 0.001), and health satisfaction (β = -0.50, 95% CI: -0.65 to - 0.35, p < 0.001) compared to those without heart disease. The heterogeneous analysis further revealed that gender differences influenced health outcomes, with females experiencing more pronounced declines across all health measures than males. Additionally, the marginal effects analysis indicated that heart disease reduced the likelihood of achieving the highest levels of self-assessed health and health satisfaction. Conclusion This study found that heart disease is linked to poorer health outcomes, including general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. To enhance the overall well-being of this population, communities, government and nongovernment organisations, and other stakeholders should prioritise routine healthcare prevention, targeted interventions, and treatment strategies, particularly for individuals affected by heart disease.. Keywords: Heart disease; general health; mental health; self-assessed health; health satisfaction STUDY 2 ABSTRACT Background Heart disease poses a significant burden on healthcare systems, particularly among middle-aged and older adults in Australia. Despite existing research on healthcare utilisation patterns, longitudinal studies focusing on how heart disease affects healthcare use over time among older Australians remain limited. The study aims to examine the longitudinal burden of heart disease on healthcare utilisation among middle-aged and older Australians, focusing on the number of doctor visits, hospital admissions, and nights spent in the hospital. Methods This longitudinal observational study utilised data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, covering the years 2009, 2013, 2017, and 2021. The study included 12,857 participants aged 40 and older, with 33,822 observations. The primary outcomes were the number of doctor visits, hospital admissions, and nights spent in the hospital. Heart disease status was the main exposure variable, and random-effects negative binomial regression models were used to examine associations, adjusting for socio-demographic, behavioural, and healthcare access factors. Results Participants with heart disease had significantly higher healthcare utilisation across all measures. The rate of doctor visits increased by 24% (IRR: 1.24, 95% CI: 1.20–1.28, p < 0.001), while hospital admissions nearly doubled (IRR: 1.91, 95% CI: 1.76–2.07, p < 0.001), and nights spent in the hospital were significantly longer (IRR: 1.89, 95% CI: 1.75–2.04, p < 0.001) compared to those without heart disease. Older age (≥ 70 years), female sex, multiple chronic conditions, and not being in the labour force were significant predictors of increased healthcare utilisation, indicating a compounded healthcare burden in these subgroups. Conclusion Heart This study shows that middle-aged and older Australians with heart disease have higher healthcare utilisation compared to those without the condition. Heart disease is a significant public health concern that necessitates comprehensive, long-term management strategies focused on prevention. Inadequate management of heart disease could lead to worsening health outcomes and place further strain on the healthcare system. Keywords: Heart disease, healthcare utilisation, longitudinal study, older adults, HILDA survey, doctor visits, hospital admissions, Australia.
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