Self management intervention to prevent weight gain in young patients with antipsychotic medication
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Johan Åhlin , Sonja Beckmann, Indre Brasaite Loreena Hill, Victoria Navarta , Eriikka Siirala PowerPoint PPT Presentation


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Self - management intervention to prevent weight gain in young patients with antipsychotic medication. Johan Åhlin , Sonja Beckmann, Indre Brasaite Loreena Hill, Victoria Navarta , Eriikka Siirala. Background to our project.

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Johan Åhlin , Sonja Beckmann, Indre Brasaite Loreena Hill, Victoria Navarta , Eriikka Siirala

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Self-management intervention to prevent weight gain in young patients with antipsychotic medication

Johan Åhlin, Sonja Beckmann, IndreBrasaite

Loreena Hill, Victoria Navarta, EriikkaSiirala


Background to our project

  • 80% of patients with psychotic mental illnesses take secondary generation antipsychotic medication (SGA)  high risk for obesityand diabetes

  • SGA increases costs for the health care system

  • Schizophrenic patients have 12-fold higher risk for cardiovascular disease, than general population

The European Academy of Nursing Science


Why our project is important

  • 15-y reduced life expectancy compared to general population (e.g. CV disease, suicide)

  • Onset of psychotic mental illness is mainly between the age of 16-25

  • Gaps in literature: no evaluation of peer / family support, key characteristics of successful behavioral interventions

  • Preventive non-pharmacological interventions for weight management can be effective, cost-efficient and beneficial, if they are offered in early stages of antipsychotic treatment.

The European Academy of Nursing Science


Our Aim

To conduct a pilot-test of a 4 component intervention, to control weight as indicator for self-management, in individuals aged of 16 to 25 years prescribed SGA in the past 6 months.

  • Taking action

  • Patient / health care provider partnership

  • Problem solving

  • Decision making

  • Resource utilization

The European Academy of Nursing Science


4 components of the intervention

webBALANCEplatform

Interactive internet platform and APP (self-monitoring of energy intake, expenditure, weight, Wii activities … )

Peer support

Exercise groups, cooking class, grocery shopping …

Booklet with information

Illness and comorbidities, side effects of medication,

contact numbers, additional links, further education programs, support groups, coping strategies…

Individual nurse counseling

Weekly face-to-face / telephone contact with patients and family, standardized intervention process, guidelines…

The European Academy of Nursing Science


Intervention in view of behavior change techniques and self-management support

The European Academy of Nursing Science


Methods

  • Design: Single case experimental studies

  • Sample: purposive, 4 male and 4 female

  • Inclusion: age 16-25, prescription SGA within the last 6 months, living in community, stable psychiatric state according to diagnosis by psychiatrist

  • Primary outcome: energy intake/expenditure in kcal/day

  • Secondary outcomes: weight, BMI, waist circumference, clinical indicators (e.g. glucose, lipids…), adherence to the intervention

  • Qualitative interviews before and after the intervention

The European Academy of Nursing Science


Difference in energyintake and expenditure

Days


Thank you for your attention


References

  • Citrome L ; Vreeland B, (2008) Schizophrenia, obesity, and antipsychotic medications: what can we do?

  • Eapen V et al (2011) Weight gain and metabolic syndrome among young patients on antipsychotic medication

  • Humphrey L.B (2008) Obesity in Schizophrenia: Screening, Monitoring, and Health Promotion

  • McLoughen et al (2012) Physical health & wellbeing

  • Alvare-Jimenez (2008)

  • Saravane D, Feve B, Frances Y, Corruble E, Lancon C, Chanson P, Maison P, Terra JL, Azorin JM; avec le soutieninstitutionnel du laboratoire Lilly. Drawing up guidelines for the attendance of physical health of patients with severe mental illness]. Encephale. 2009 Sep;35(4):330-9.

  • Ward et al (2013) journal of Pharmacy and therapeutics – indicate increasings costs with the medication

  • Wagner, E. H., Austin, B. T., & Korff, M. V. (1996). Improving Outcomes in Chronic Illness. Managed Care Quarterly, 4, 2, 12-25

  • Vandyk & Baker ( 2012)

  • Morgan & Morgan (2009) Single case research methods for the behavioral and health sciences: London: sage

The European Academy of Nursing Science


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