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

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

The European Academy of Nursing Science


Methods
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


Johan hlin sonja beckmann indre brasaite loreena hill victoria navarta eriikka siirala

Difference in energyintake and expenditure

Days


Thank you for your attention
Thank you for your attention


References
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