Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Pape, Laura Michelle; Adriaanse, Marcel C.; Kol, Jelle; Straten, Annemieke van; Meijel, Berno van

doi:10.1186/s12888-022-03854-x

Cited by 15 publications

(16 citation statements)

References 83 publications

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“…Furthermore, the ACHIEVE study showed 2.5kg (95% CI, -4.1 to -0.8) weight reduction compared with controls after 12 months, and 3.2kg (95% CI, -5.1 to -1.2) after 18 months. We did not find an effect of SMILE on quality of life, in line with results from other lifestyle interventions (27). Finally, research suggests that lifestyle interventions may have positive effects on depression and anxiety severity (27), not measured in this study.…”

Section: Discussionsupporting

confidence: 85%

“…We did not find an effect of SMILE on quality of life, in line with results from other lifestyle interventions (27). Finally, research suggests that lifestyle interventions may have positive effects on depression and anxiety severity (27), not measured in this study. Future researchers should consider more patient-reported outcomes as they are beneficial to people with SMI.…”

Section: Discussionsupporting

confidence: 85%

“…Quality of life is a frequently reported patient-reported outcome in lifestyle interventions in this target population. However, a significant and clinically relevant effect on this outcome has not been identified in most studies (27). A meta-analysis looking at patient-reported outcomes described that the rewarding element for patients could be of great importance.…”

Section: Discussionmentioning

confidence: 99%

“…For people with SMI, the 2018 WHO guidelines recommend that lifestyle interventions be primary General introduction strategies for physical health management (26). In recent years, many lifestyle intervention studies have been conducted to improve the physical health of people with SMI (27,28). Interventions have successfully reduced body weight and improved mental health outcomes such as depression and anxiety symptoms.…”

Section: Lifestyle Interventions For People With a Severe Mental Illnessmentioning

confidence: 99%

“…An increasing number of clinical guidelines for mental health care for people with SMI include a focus on physical health (4). Although many studies have been conducted (4,27), evidence for long-term sustainability of lifestyle interventions for people with SMI is still limited (40,57,151,152), and implementation into routine care is lacking (40,68). Also, little is known regarding the cost-effectiveness of lifestyle interventions within this population as studies often do not describe cost data or address cost-effectiveness (4,38,57,153).…”

Section: Introductionmentioning

confidence: 99%

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The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

Walburg¹

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In this thesis, we present a pragmatic RCT evaluating the effectiveness of an intervention (SMILE) targeting lifestyle changes in people with SMI. Alongside, we performed three sub-studies: a process evaluation to gain insight into the feasibility of the intervention in FACT-care practice; a qualitative study on the experiences of people with SMI and their health care professionals with the SMILE intervention; and finally an economic evaluation of the cost-effectiveness of the intervention. We included patients with overweight or obesity, as they were expected to make the greatest health gains from the SMILE intervention. The SMILE intervention is a feasible way to contribute to the physical health through weight loss of people with SMI in a group setting in Dutch ambulatory mental health care. The intervention was well-perceived by both mental health care professionals and clients who participated in the intervention. The intervention was generally well implemented during the trial and showed positive effects for weight change. In addition, the SMILE intervention was found to be cost-effective for weight loss but not for increased QALYs. Physical health and lifestyle behaviours should be integrated into treatments in this population and the SMILE intervention seems to be a promising way to offer clients with SMI support in improving their lifestyle.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Lifestyle Interventions For People With a Severe Mental Illnessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

Walburg¹

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Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

et al. 2023

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ImportancePeople with a severe mental illness (SMI) have a life expectancy reduced by 10 to 20 years compared with the general population, primarily attributable to cardiometabolic disorders. Lifestyle interventions for people with SMI can improve health and reduce cardiometabolic risk.ObjectiveTo evaluate the effectiveness of a group-based lifestyle intervention among people with SMI in outpatient treatment settings compared with treatment as usual (TAU).Design, Setting, and ParticipantsThe Severe Mental Illness Lifestyle Evaluation (SMILE) study is a pragmatic cluster randomized clinical trial performed in 8 mental health care centers with 21 flexible assertive community treatment teams in the Netherlands. Inclusion criteria were SMI, age of 18 years or older, and body mass index (calculated as weight in kilograms divided by height in meters squared) of 27 or greater. Data were collected from January 2018 to February 2020, and data were analyzed from September 2020 to February 2023.InterventionsWeekly 2-hour group sessions for 6 months followed by monthly 2-hour group sessions for another 6 months, delivered by trained mental health care workers. The intervention targeted overall lifestyle changes, emphasizing establishing a healthy diet and promoting physical activity. TAU (control) did not include structured interventions or advice on lifestyle.Main Outcomes and MeasuresCrude and adjusted linear mixed models and multivariable logistic regression analyses were performed. The main outcome was body weight change. Secondary outcomes included changes in body mass index, blood pressure, lipid profiles, fasting glucose level, quality of life, self-management ability, and lifestyle behaviors (physical activity and health, mental health, nutrition, and sleep).ResultsThe study population included 11 lifestyle intervention teams (126 participants) and 10 TAU teams (98 participants). Of 224 included patients, 137 (61.2%) were female, and the mean (SD) age was 47.6 (11.1) years. From baseline to 12 months, participants in the lifestyle intervention group lost 3.3 kg (95% CI, −6.2 to −0.4) more than those in the control group. In the lifestyle intervention group, people with high attendance rates lost more weight than participants with medium and low rates (mean [SD] weight loss: high, −4.9 [8.1] kg; medium, −0.2 [7.8] kg; low, 0.8 [8.3] kg). Only small or no changes were found for secondary outcomes.Conclusions and RelevanceIn this trial, the lifestyle intervention significantly reduced weight from baseline to 12 months in overweight and obese adults with SMI. Tailoring lifestyle interventions and increasing attendance rates might be beneficial for people with SMI.Trial RegistrationNetherlands Trial Register Identifier: NTR6837

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Effects of web-based adapted physical activity on hippocampal plasticity, cardiorespiratory fitness, symptoms, and cardiometabolic markers in patients with schizophrenia: a randomized, controlled study

Leroux,

Tréhout,

Reboursiere

et al. 2024

Eur Arch Psychiatry Clin Neurosci

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Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Cited by 15 publications

References 83 publications

The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

The SMILE lifestyle intervention for people with a severe mental illness: feasibility and (cost-)effectiveness

Effectiveness of a Lifestyle Intervention for People With a Severe Mental Illness in Dutch Outpatient Mental Health Care

Effects of web-based adapted physical activity on hippocampal plasticity, cardiorespiratory fitness, symptoms, and cardiometabolic markers in patients with schizophrenia: a randomized, controlled study

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