Improving cardiovascular health and quality of life in people with severe mental illness: study protocol for a randomised controlled trial

Abstract

BackgroundThe estimated 300,000 adults in Australia with severe mental illness (SMI) have markedly reduced life expectancy compared to the general population, mainly due to physical health comorbidities. Cardiovascular disease (CVD) is the commonest cause of early death and people with SMI have high rates of most modifiable risk factors, with associated quality of life (QoL) reduction. High blood pressure, smoking, dyslipidaemia, diabetes and obesity are major modifiable CVD risk factors. Poor delivery of recommended monitoring and risk reduction is a national and international problem. Therefore, effective preventive interventions to safeguard and support physical health are urgently needed in this population.MethodsThis trial used a rigorous process, including extensive piloting, to develop an intervention that delivers recommended physical health care to reduce CVD risk and improve QoL for people with SMI. Components of this intervention are integrated using the Flinders Program of chronic condition management (CCM) which is a comprehensive psychosocial care planning approach that places the patient at the centre of their care, and focuses on building their self-management capacity within a collaborative approach, therefore providing a recovery-oriented framework. The primary project aim is to evaluate the effectiveness and health economics of the CCM intervention. The main outcome measures examine CVD risk and quality of life. The second aim is to identify essential components, enablers and barriers at patient, clinical and organisational levels for national, sustained implementation of recommended physical health care delivery to people with SMI. Participants will be recruited from a community-based public psychiatric service.DiscussionThis study constitutes the first large-scale trial, worldwide, using the Flinders Program with this population. By combining a standardised yet flexible motivational process with a targeted set of evidence-based interventions, the chief aim is to reduce CVD risk by 20%. If achieved, this will be a ground-breaking outcome, and the program will be subsequently translated nationwide and abroad. The trial will be of great interest to people with mental illness, family carers, mental health services, governments and primary care providers because the Flinders Program can be delivered in diverse settings by any clinical discipline and supervised peers.Trial registrationAustralian and New Zealand Clinical Trials Registry, ACTRN12617000474358. Registered on 31 March 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2748-7) contains supplementary material, which is available to authorized users.

Prediction of carotid plaque by blood biochemical indices and related factors based on Fisher discriminant analysis

“…FDA was used to predict clinical decisions made by physicians and the outcomes of clinical activity for conditions based on patient features, the model has been applied to predict breast cancer, diabetes 2, and other diseases [8][9][10][11][12]. The establishment of an effective discriminant model has reference significance for early identification of patients with carotid plaque formation in the population, saving social resources for chronic disease prevention and control, and formulating follow-up clinical treatment plans [13][14][15].…”

Assessment of the quality of life of patients with mental disorders using general questionnaires

“…Suicide occurs in 10-13% of patients and is the most common cause of death in the group of schizophrenic patients (Górna et al, 2010). The risk of premature death is also higher due to somatic comorbidities (obesity, diabetes, cardiovascular diseases) and an unhealthy lifestyle, which reduce life expectancy of schizophrenic patients by 13-30 years (Battersby et al, 2018;Martens et al, 2021;Perez-Cruzado et al, 2018). Recent years have brought an increase in interest in research investigating the quality of life (QoL) in people with different types of disorders (Cieślik, 2022;Wnuk and Marcinkowski, 2013).…”

“…Do samobójstwa dochodzi u 10-13% chorych, stanowi ono najczęstszą przyczynę śmierci w grupie pacjentów ze schizofrenią (Górna et al, 2010). Ryzyko przedwczesnej śmierci jest ponadto wyższe z powodu współwystępowania schorzeń somatycznych (otyłości, cukrzycy, chorób układu sercowo--naczyniowego) oraz niezdrowego trybu życia, co skraca życie chorych na schizofrenię o 13-30 lat (Battersby et al, 2018;Martens et al, 2021;Perez-Cruzado et al, 2018). Ostatnie lata przyniosły wzrost zainteresowania badaniami jakości życia (quality of life, QoL) osób z różnego typu schorzeniami (Cieślik, 2022;Wnuk i Marcinkowski, 2013).…”