Living with diabetes alongside a severe mental illness: A qualitative exploration with people with severe mental illness, family members and healthcare staff.
bipolar and related disorders
co-morbidity
delivery of healthcare
diabetes mellitus
schizophrenia spectrum and other psychotic disorders
self management
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
24
02
2021
received:
09
09
2020
accepted:
24
03
2021
pubmed:
28
3
2021
medline:
29
3
2022
entrez:
27
3
2021
Statut:
ppublish
Résumé
Diabetes is two to three times more prevalent in people with severe mental illness, yet little is known about the challenges of managing both conditions from the perspectives of people living with the co-morbidity, their family members or healthcare staff. Our aim was to understand these challenges and to explore the circumstances that influence access to and receipt of diabetes care for people with severe mental illness. Framework analysis of qualitative semi-structured interviews with people with severe mental illness and diabetes, family members, and staff from UK primary care, mental health and diabetes services, selected using a maximum variation sampling strategy between April and December 2018. In all, 39 adults with severe mental illness and diabetes (3 with type 1 diabetes and 36 with type 2 diabetes), nine family members and 30 healthcare staff participated. Five themes were identified: (a) Severe mental illness governs everyday life including diabetes management; (b) mood influences capacity and motivation for diabetes self-management; (c) cumulative burden of managing multiple physical conditions; (d) interacting conditions and overlapping symptoms and (e) support for everyday challenges. People living with the co-morbidity and their family members emphasised the importance of receiving support for the everyday challenges that impact diabetes management, and identified barriers to accessing this from healthcare providers. More intensive support for diabetes management is needed when people's severe mental illness (including symptoms of depression) or physical health deteriorates. Interventions that help people, including healthcare staff, distinguish between symptoms of diabetes and severe mental illness are also needed.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14562Subventions
Organisme : Department of Health
ID : 15/70/26
Pays : United Kingdom
Informations de copyright
© 2021 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Références
Hardoon S, Hayes JF, Blackburn R, et al. Recording of severe mental illness in United Kingdom primary care, 2000-2010. PLoS One. 2013;8(12):e82365.
Merrick J, Merrick E. Equal treatment: closing the gap. A formal investigation into physical health inequalities experienced by people with learning disabilities and/or mental health problems. JPPID. 2007. https://doi.org/10.1111/j.1741-1130.2006.00100.x
Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51(Suppl):S28-S40.
Royal College of Psychiatrists. Report of the second round of the National Audit of Schizophrenia (NAS) 2014. London, UK: Healthcare Quality Improvement Partnership; 2014.
Vinogradova Y, Coupland C, Hippisley-Cox J, et al. Effects of severe mental illness on survival of people with diabetes. Br J Psychiatry. 2010;197(4):272-277.
Ward M, Druss B. The epidemiology of diabetes in psychotic disorders. Lancet Psychiatry. 2015;2(5):431-451.
Stubbs B, Vancampfort D, De Hert M, Mitchell AJ. The prevalence and predictors of type two diabetes mellitus in people with schizophrenia: a systematic review and comparative meta-analysis. Acta Psychiatr Scand. 2015;132(2):144-157.
Das-Munshi J, Ashworth M, Dewey ME, et al. Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross-sectional analysis of 588 408 records from the UK. Diabet Med. 2017;34(7):916-924.
Chang C-K, Hayes RD, Perera G, et al. Life expectancy at birth for people with serious mental illness and other major disorders from a secondary mental health care case register in London. PLoS One. 2011;6(5):e19590.
De Hert M, Cohen D, Bobes J, et al. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry. 2011;10(2):138-151.
Brown S, Kim M, Mitchell C, Inskip H. Twenty-five year mortality of a community cohort with schizophrenia. Br J Psychiatry. 2010;196(2):116-121.
Woodhead C, Ashworth M, Schofield P, Henderson M. Patterns of physical co-/multi-morbidity among patients with serious mental illness: a London borough-based cross-sectional study. BMC Family Practice. 2014;15:117.
Osborn DPJ, Wright CA, Levy G, King MB, Deo R, Nazareth I. Relative risk of diabetes, dyslipidaemia, hypertension and the metabolic syndrome in people with severe mental illnesses: systematic review and metaanalysis. BMC Psychiatry. 2008;8:84.
Scott D, Platania-Phung C, Happell B. Quality of care for cardiovascular disease and diabetes amongst individuals with serious mental illness and those using antipsychotic medications. J Healthc Qual. 2012;34(5):15-21.
Wu C-S, Lai M-S, Gau SS-F. Complications and mortality in patients with schizophrenia and diabetes: population-based cohort study. Br J Psychiatry. 2015;207(5):450-457.
Stahl SM, Mignon L, Meyer JM. Which comes first: atypical antipsychotic treatment or cardiometabolic risk? Acta Psychiatr Scand. 2009;119(3):171-179.
Llorente MD, Urrutia V. Diabetes, psychiatric disorders, and the metabolic effects of antipsychotic medications. Clin Diabetes. 2006;24(1):18.
Rummel-Kluge C, Komossa K, Schwarz S, et al. Head-to-head comparisons of metabolic side effects of second generation antipsychotics in the treatment of schizophrenia: a systematic review and meta-analysis. Schizophr Res. 2010;123(2):225-233.
Kilbourne AM, Rofey DL, McCarthy JF, Post EP, Welsh D, Blow FC. Nutrition and exercise behavior among patients with bipolar disorder. Bipolar Disord. 2007;9(5):443-452.
Banham L, Gilbody S. Smoking cessation in severe mental illness: what works? Addiction. 2010;105(7):1176-1189.
Holt RIG. Cardiovascular disease and diabetes in people with severe mental illness: causes, consequences and pragmatic management: review. S Afr J Diabetes Vasc Dis. 2012;9(3):107-111.
Stubbs B, Williams J, Gaughran F, Craig T. How sedentary are people with psychosis? A systematic review and meta-analysis. Schizophr Res. 2016;171(1-3):103-109.
Onwumere J, Howes S, Shiers D, Gaughran F. Physical health problems in people with psychosis: the issue for informal carers. Int J Soc Psychiatry. 2018;64(4):381-388.
Mulligan K, McBain H, Lamontagne-Godwin F, et al. Barriers and enablers of type 2 diabetes self-management in people with severe mental illness. Health Expect. 2017;20(5):1020-1030.
Mulligan K, McBain H, Lamontagne-Godwin F, et al. Barriers to effective diabetes management - a survey of people with severe mental illness. BMC Psychiatry. 2018;18(1):165.
Bellass S, Taylor J, Han LU, et al. Exploring severe mental illness and diabetes: protocol for a longitudinal, observational, and qualitative mixed methods study. JMIR Res Protoc. 2019;8(9):13407.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-357.
Patton MQ. Qualitative evaluation and research methods. 2nd ed. Thousand Oaks, CA: SAGE Publications; 1990.
Public Health England. National general practice profiles. https://fingertips.phe.org.uk/profile/general-practice (accessed 24 February 2021).
Taylor J, Lister JE, Boehnke J, et al. The psychosocial impact of having diabetes alongside severe mental illness: comparing results from the Diabetes Attitudes, Wishes and Needs-Severe Mental Illness (DAWN-SMI) and Diabetes Attitudes, Wishes and Needs Second (DAWN2) studies. Education, Clinical Care and Lifestyle. Diabet Med. 2019;36:9-11.