Outcome of a psychosocial health promotion intervention aimed at improving physical health and reducing alcohol use in patients with schizophrenia and psychotic disorders (MINT).


Journal

Schizophrenia research
ISSN: 1573-2509
Titre abrégé: Schizophr Res
Pays: Netherlands
ID NLM: 8804207

Informations de publication

Date de publication:
06 2019
Historique:
received: 18 12 2017
revised: 23 02 2019
accepted: 26 03 2019
pubmed: 14 4 2019
medline: 3 7 2020
entrez: 14 4 2019
Statut: ppublish

Résumé

Life expectancy is reduced by 19 years in men and 17 in women with psychosis in Sweden, largely due to cardiovascular disease. Assess whether a psychosocial health promotion intervention improves cardiometabolic risk factors, quality of life, and severity of illness in patients with psychotic disorders more than treatment as usual. A pragmatic intervention trial testing a manual-based multi-component health promotion intervention targeting patients with psychosis. The Swedish intervention was adapted from IMPaCT therapy, a health-promotion program based on motivational interviewing and cognitive behavioral therapy, designed to be incorporated into routine care. The intervention group consisted of 119 patients and the control group of 570 patients from specialized psychosis departments. Outcome variables were assessed 6 months before intervention during the run-in period, again at the start of intervention, and 12 months after the intervention began. The control group received treatment as usual. The intervention had no significant effect on any of the outcome variables. However, BMI, waist circumference, systolic BP, heart rate, HbA1c, general health, and Clinical Global Impressions Scale score improved significantly during the run-in period before the start of the active intervention (observer effect). The multi-component design meant that treatment effects could only be calculated for the intervention as a whole. The results of the intervention are similar to those of the U.K. IMPaCT study, in which the modular health-promotion intervention had little effect on cardiovascular risk indicators. However, in the current study, the run-in period had a positive effect on cardiometabolic risk factors.

Sections du résumé

BACKGROUND
Life expectancy is reduced by 19 years in men and 17 in women with psychosis in Sweden, largely due to cardiovascular disease.
AIM
Assess whether a psychosocial health promotion intervention improves cardiometabolic risk factors, quality of life, and severity of illness in patients with psychotic disorders more than treatment as usual.
METHODS
A pragmatic intervention trial testing a manual-based multi-component health promotion intervention targeting patients with psychosis. The Swedish intervention was adapted from IMPaCT therapy, a health-promotion program based on motivational interviewing and cognitive behavioral therapy, designed to be incorporated into routine care. The intervention group consisted of 119 patients and the control group of 570 patients from specialized psychosis departments. Outcome variables were assessed 6 months before intervention during the run-in period, again at the start of intervention, and 12 months after the intervention began. The control group received treatment as usual.
RESULTS
The intervention had no significant effect on any of the outcome variables. However, BMI, waist circumference, systolic BP, heart rate, HbA1c, general health, and Clinical Global Impressions Scale score improved significantly during the run-in period before the start of the active intervention (observer effect). The multi-component design meant that treatment effects could only be calculated for the intervention as a whole.
CONCLUSION
The results of the intervention are similar to those of the U.K. IMPaCT study, in which the modular health-promotion intervention had little effect on cardiovascular risk indicators. However, in the current study, the run-in period had a positive effect on cardiometabolic risk factors.

Identifiants

pubmed: 30979666
pii: S0920-9964(19)30120-3
doi: 10.1016/j.schres.2019.03.026
pii:
doi:

Substances chimiques

Glycated Hemoglobin A 0
hemoglobin A1c protein, human 0

Types de publication

Journal Article Pragmatic Clinical Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

138-144

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Auteurs

Jeanette Westman (J)

Dept of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Academic Primary Health Care Centre, Region Stockholm, Sweden. Electronic address: jeanette.westman@ki.se.

Jonas Eberhard (J)

Division of Psychiatry, Dept of Clinical Sciences, Lund University, Lund, Sweden; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Fiona P Gaughran (FP)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.

Lennart Lundin (L)

Sahlgrenska University Hospital, Gothenburg, Sweden; Swedish Schizophrenia Fellowship, Stockholm, Sweden.

Richard Stenmark (R)

Division of Psychiatry, Dept of Clinical Sciences, Lund University, Lund, Sweden.

Gunnar Edman (G)

Norrtälje Hospital, Tiohundra AB, Norrtälje, Sweden; Dept of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.

Sven V Eriksson (SV)

Department of Internal Medicine, Enköping Hospital, Enköping, Sweden; Aleris Specialist Care, Gothenburg, Sweden.

Erik Jedenius (E)

Dept of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Division of Psychiatry, Dept of Clinical Sciences, Lund University, Lund, Sweden.

Pia Rydell (P)

Sahlgrenska University Hospital, Gothenburg, Sweden.

Karin Overgaard (K)

Sahlgrenska University Hospital, Gothenburg, Sweden.

Daniel Abrams (D)

Sahlgrenska University Hospital, Gothenburg, Sweden.

Kathryn E Greenwood (KE)

School of Psychology, University of Sussex, Brighton, UK; Sussex Partnership NHS Foundation Trust, UK.

Shubulade Smith (S)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.

Khalida Ismail (K)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

Robin Murray (R)

Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.

Urban Ösby (U)

Dept of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden.

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Classifications MeSH