None listed
Conditions
Brief summary
Individuals experiencing psychosis are 2-3 times more likely to have comorbid cardiometabolic illness, and die 10-25 years prematurely compared to the general population. Despite this, consumers receive rates of cardiometabolic care as low as 3%. There remains a critical implementation gap around delivering a high standard of cardiometabolic care within Australia’s current health service and policy landscape. Based on the best available evidence and preliminary studies, our team developed the Physical Health Nurse Consultant (PHNC) service that is offered alongside usual mental health care. The PHNC service offers cardiometabolic assessment, risk management and care coordination, and overcomes barriers including stigma, consumer disempowerment and lack of specialist health knowledge. The objective of this project is to evaluate whether the PHNC role alongside usual care (compared to usual care alone) results in improvements in Burden of Disease risk factors, consumer experience of care, and cost-effectiveness in an 24 month, 2 group RCT. Evaluating consumer experience is a key innovative feature of the methodology that addresses a critical knowledge gap around the influence of consumer experience and participation in care on Burden of Disease risk factors. Outcomes are expected to result in a significant advance in knowledge on implementing and delivering physical health care within mental health services. Outcomes will also have a substantial impact on health policy given the National Mental Health Commission is seeking solutions for this priority issue. Our experienced project team includes highly influential senior members and an outstanding early career researcher with a depth and breadth of expertise that includes mental health nursing, psychiatry, consumer participation, health economics, statistics, health services and physical health research.
Interventions
1. Cardiometabolic assessment undertaken by the Clinical Research Assistant. The assessment will comprise measurement of weight, height, triglycerides, HDL cholesterol, blood pressure, fasting plasma glucose, and assessment of health behaviours including smoking, nutrition, alcohol and physical activity. This will be one session of approximately 60 minutes duration. It will be repeated at each primary time point.
2. Risk management: The Physical Health Nurse Consultant (PHNC) will apply the
1. Cardiometabolic assessment undertaken by the Clinical Research Assistant. The assessment will comprise measurement of weight, height, triglycerides, HDL cholesterol, blood pressure, fasting plasma glucose, and assessment of health behaviours including smoking, nutrition, alcohol and physical activity. This will be one session of approximately 60 minutes duration. It will be repeated at each primary time point. 2. Risk management: The Physical Health Nurse Consultant (PHNC) will apply the Positive Cardiometabolic Health treatment framework based on assessment data and any additional information discussed with the consumer. The Cardiometabolic Health Treatment Framework was developed by Professor Jackie Curtis (member of the research team). It involves the assessment of risk based on the Cardiometabolic Health Assessment comprising: weight, height, triglycerides, HDL cholesterol, blood pressure, fasting plasma glucose, and assessment of health behaviours including smoking, nutrition, alcohol and physical activity. 3. Care coordination: Once the PHNC and consumer agree on an approach to physical healthcare, the PHNC provides care coordination including supported referral to appropriate programmes or services (GPs, dietitians, nutritionists, accredited exercise physiologists, weight loss centres, smoking cessation programs and other available services) as recommended by the treatment framework, communicates relevant clinical history, provides appointment reminders, and timely follow-up of results. Parts 2 and 3 will occur in one appointment of approximately 45 minutes duration and will be repeated at each primary time point.
Sponsors
University of Newcastle
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Consumers attending City Mental Health aged 18-65, diagnosed with a DSM-5 psychotic disorder will be eligible to participate.
Exclusion criteria
Consumers will be excluded if they are unable to speak and read English, or unable or unwilling to provide informed consent
Outcome results
None listed