Exploring Severe Mental Illness and Diabetes: Protocol for a Longitudinal, Observational, and Qualitative Mixed Methods Study.
bipolar disorder
diabetes complications
diabetes mellitus
schizophrenia
Journal
JMIR research protocols
ISSN: 1929-0748
Titre abrégé: JMIR Res Protoc
Pays: Canada
ID NLM: 101599504
Informations de publication
Date de publication:
06 09 2019
06 09 2019
Historique:
received:
15
01
2019
accepted:
28
04
2019
revised:
11
04
2019
entrez:
8
9
2019
pubmed:
8
9
2019
medline:
8
9
2019
Statut:
epublish
Résumé
The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolar disorder is 15 to 20 years less than that for the population as a whole. Diabetes contributes significantly to this inequality, being 2 to 3 times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychotic medication and unhealthy lifestyles, which often occur in the context of socioeconomic disadvantage and health care inequality. However, little is known about how these factors may interact to influence the risk of developing diabetes and poor diabetic outcomes, or how the organization and provision of health care may contribute. This study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people with SMI. This study will employ a concurrent mixed methods design combining the interrogation of electronic primary care health records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI and diabetes, their relatives and friends, and health care staff. The study has been funded for 2 years, from September 2017 to September 2019, and data collection has recently ended. CPRD and linked health data will be used to explore the association of sociodemographics, illness, and health care-related factors with both the development and outcomes of type 2 diabetes in people with SMI. Experiences of managing the comorbidity and accessing health care will be explored through qualitative interviews using topic guides informed by evidence synthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions, and outcomes for people with SMI. Findings will be translated into recommendations for interventions and services using co-design workshops. Improving diabetes outcomes for people with SMI is a high-priority area nationally and globally. Understanding how risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessary first step in developing health care interventions to improve outcomes for people with diabetes and SMI. ClinicalTrials.gov NCT03534921; https://clinicaltrials.gov/ct2/show/NCT03534921.
Sections du résumé
BACKGROUND
The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolar disorder is 15 to 20 years less than that for the population as a whole. Diabetes contributes significantly to this inequality, being 2 to 3 times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychotic medication and unhealthy lifestyles, which often occur in the context of socioeconomic disadvantage and health care inequality. However, little is known about how these factors may interact to influence the risk of developing diabetes and poor diabetic outcomes, or how the organization and provision of health care may contribute.
OBJECTIVE
This study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people with SMI.
METHODS
This study will employ a concurrent mixed methods design combining the interrogation of electronic primary care health records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI and diabetes, their relatives and friends, and health care staff. The study has been funded for 2 years, from September 2017 to September 2019, and data collection has recently ended.
RESULTS
CPRD and linked health data will be used to explore the association of sociodemographics, illness, and health care-related factors with both the development and outcomes of type 2 diabetes in people with SMI. Experiences of managing the comorbidity and accessing health care will be explored through qualitative interviews using topic guides informed by evidence synthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions, and outcomes for people with SMI. Findings will be translated into recommendations for interventions and services using co-design workshops.
CONCLUSIONS
Improving diabetes outcomes for people with SMI is a high-priority area nationally and globally. Understanding how risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessary first step in developing health care interventions to improve outcomes for people with diabetes and SMI.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03534921; https://clinicaltrials.gov/ct2/show/NCT03534921.
Identifiants
pubmed: 31493324
pii: v8i9e13407
doi: 10.2196/13407
pmc: PMC6786849
doi:
Banques de données
ClinicalTrials.gov
['NCT03534921']
Types de publication
Journal Article
Langues
eng
Pagination
13407Subventions
Organisme : Department of Health
ID : 15/70/26
Pays : United Kingdom
Organisme : Department of Health
ID : HS&DR/15/70/26
Pays : United Kingdom
Informations de copyright
©Sue Bellass, Johanna Taylor, Lu Han, Stephanie L Prady, David Shiers, Rowena Jacobs, Richard Ian Gregory Holt, John Radford, Simon Gilbody, Catherine Hewitt, Tim Doran, Sarah L Alderson, Najma Siddiqi. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 06.09.2019.
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