Experiences and views of Dutch general practitioners regarding physician-assisted death for patients suffering from severe mental illness: a mixed methods approach

Abstract Background People with severe mental illness (SMI) have an increased risk of premature mortality, predominantly due to somatic health conditions. Evidence indicates that primary and tertiary prevention and improved treatment of somatic conditions in patients with SMI could reduce this excess mortality. This paper reports a protocol designed to evaluate the feasibility of a coordinated co-produced care program (SOFIA model, a Danish acronym for Severe Mental Illness and Physical Health in General Practice) in the general practice setting to reduce mortality and improve quality of life in patients with severe mental illness. Methods The SOFIA pilot trial is designed as a cluster randomized controlled trial targeting general practices in two regions in Denmark. We aim to include 12 practices, each of which is instructed to recruit up to 15 community-dwelling patients aged 18 and older with SMI. Practices will be randomized by a computer in a ratio of 2:1 to deliver a coordinated care program or usual care during a 6-month study period. A randomized algorithm is used to perform randomization. The coordinated care program includes educational training of general practitioners and their clinical staff educational training of general practitioners and their clinical staff, which covers clinical and diagnostic management and focus on patient-centered care of this patient group, after which general practitioners will provide a prolonged consultation focusing on individual needs and preferences of the patient with SMI and a follow-up plan if indicated. The outcomes will be parameters of the feasibility of the intervention and trial methods and will be assessed quantitatively and qualitatively. Assessments of the outcome parameters will be administered at baseline, throughout, and at end of the study period. Discussion If necessary the intervention will be revised based on results from this study. If delivery of the intervention, either in its current form or after revision, is considered feasible, a future, definitive trial to determine the effectiveness of the intervention in reducing mortality and improving quality of life in patients with SMI can take place. Successful implementation of the intervention would imply preliminary promise for addressing health inequities in patients with SMI. Trial registration The trial was registered in Clinical Trials as of November 5, 2020, with registration number NCT04618250. Protocol version: January 22, 2021; original version

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Utilising acupuncture for mental health; a mixed‐methods approach to understanding the awareness and experience of general practitioners and acupuncturists

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2020.101114 ◽

2020 ◽

Vol 39 ◽

pp. 101114

Author(s):

Kate Roberts ◽

Anthony Dowell ◽

Jing-Bao Nie

Keyword(s):

Mental Health ◽

Mixed Methods ◽

General Practitioners ◽

Mixed Methods Approach

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An Integrative Review of Recovery Services to Improve the Lives of Adults Living with Severe Mental Illness

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168873 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8873

Author(s):

Eric Badu ◽

Anthony O’Brien ◽

Rebecca Mitchell

Keyword(s):

Mental Illness ◽

Mixed Methods ◽

Severe Mental Illness ◽

Mental Health Professionals ◽

Social Inclusion ◽

Integrative Review ◽

Art Making ◽

Placement Services ◽

Integrated Recovery ◽

Individual Placement

There is an increasing call for recovery-oriented services but few reviews have been undertaken regarding such interventions. This review aims to synthesize evidence on recovery services to improve the lives of adults living with severe mental illness. An integrative review methodology was used. We searched published literature from seven databases: Medline, EMBASE, PsycINFO, CINAHL, Google Scholar, Web of Science, and Scopus. Mixed-methods synthesis was used to analyse the data. Out of 40 included papers, 62.5% (25/40) used quantitative data, 32.5% used qualitative and 5% (2/40) used mixed methods. The participants in the included papers were mostly adults with schizophrenia and schizoaffective disorder. This review identified three recovery-oriented services—integrated recovery services, individual placement services and recovery narrative photovoice and art making. The recovery-oriented services are effective in areas such as medication and treatment adherence, improving functionality, symptoms reduction, physical health and social behaviour, self-efficacy, economic empowerment, social inclusion and household integration. We conclude that mental health professionals are encouraged to implement the identified recovery services to improve the recovery goals of consumers.

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Exploring Severe Mental Illness and Diabetes: Protocol for a Longitudinal, Observational, and Qualitative Mixed Methods Study

JMIR Research Protocols ◽

10.2196/13407 ◽

2019 ◽

Vol 8 (9) ◽

pp. e13407 ◽

Cited By ~ 1

Author(s):

Sue Bellass ◽

Johanna Taylor ◽

Lu Han ◽

Stephanie L Prady ◽

David Shiers ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Mental Illness ◽

Mixed Methods ◽

Severe Mental Illness ◽

Qualitative Interviews ◽

Care Staff ◽

Clinical Practice Research Datalink ◽

Diabetes Outcomes ◽

Diabetic Outcomes

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

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Group music therapy for severe mental illness: a randomized embedded-experimental mixed methods study

Acta Psychiatrica Scandinavica ◽

10.1111/acps.12224 ◽

2013 ◽

Vol 130 (2) ◽

pp. 144-153 ◽

Cited By ~ 30

Author(s):

D. Grocke ◽

S. Bloch ◽

D. Castle ◽

G. Thompson ◽

R. Newton ◽

...

Keyword(s):

Mental Illness ◽

Mixed Methods ◽

Music Therapy ◽

Severe Mental Illness ◽

Mixed Methods Study ◽

Group Music Therapy

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The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

Systematic Reviews ◽

10.1186/s13643-021-01586-9 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Dolly Sud ◽

Eileen Laughton ◽

Robyn McAskill ◽

Eleanor Bradley ◽

Ian Maidment

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Mental Illness ◽

Mixed Methods ◽

Severe Mental Illness ◽

Cardiometabolic Risk ◽

Implementation Strategies ◽

Face To Face ◽

Study Intervention

Abstract Background Individuals with severe mental illness, e.g. schizophrenia have up to a 20% shortened life expectancy compared to the general population. Cardiovascular disease, due to cardiometabolic risk and metabolic syndrome, accounts for most of this excess mortality. A scoping search revealed that there has not been a review of published studies on the role of pharmacy in relation to cardiometabolic risk, metabolic syndrome and related diseases (e.g. type 2 diabetes) in individuals with severe mental illness. Methods A mixed-methods systematic review was performed. Eleven databases were searched using a comprehensive search strategy to identify English-language studies where pharmacy was involved in an intervention for cardiometabolic risk, metabolic syndrome or related diseases in severe mental illness in any study setting from any country of origin. First, a mapping review was conducted. Then, implementation strategies used to implement the study intervention were classified using the Cochrane Effective Practice and Organisation of Care Taxonomy. Impact of the study intervention on the process (e.g. rate of diagnosis of metabolic syndrome) and clinical (e.g. diabetic control) outcomes were analysed where possible (statistical tests of significance obtained for quantitative outcome parameters reported). Quality assessment was undertaken using a modified Mixed Methods Appraisal Tool. Results A total of 33 studies were identified. Studies were heterogeneous for all characteristics. A total of 20 studies reported quantitative outcome data that allowed for detailed analysis of the impact of the study intervention. The relationship between the total number of implementation strategies used and impact on outcomes measured is unclear. Inclusion of face-to-face interaction in implementation of interventions appears to be important in having a statistically significantly positive impact on measured outcomes even when used on its own. Few studies included pharmacy staff in community or general practitioner practices (n = 2), clinical outcomes, follow up of individuals after implementation of interventions (n = 3). No studies included synthesis of qualitative data. Conclusions Our findings indicate that implementation strategies involving face-to-face interaction of pharmacists with other members of the multidisciplinary team can improve process outcomes when used as the sole strategy. Further work is needed on clinical outcomes (e.g. cardiovascular risk reduction), role of community pharmacy and qualitative studies. Systematic review registration PROSPERO CRD42018086411

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