Examining the effects of national initiatives to improve the physical health of people with psychosis in England: secondary analysis of data from the National Clinical Audit of Psychosis

Williams, Ruth; Natkulasingam, Sagana; Tooke, Beatrice; Webster, Ella M.; Quirk, Alan; Gupta, Veenu; French, Paul; Smith, Jo; Crawford, Mike

doi:10.1192/bjb.2021.38

Cited by 3 publications

(2 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was followed by a series of policy initiatives, financial incentives and public backing of senior leaders and clinicians [46,47]. Since then the proportion of people with psychosis who receive regular physical health checks and interventions for metabolic side effects of antipsychotic medications has increased [48] and there are early signs that this is beginning to have an impact on people's health [49,50].…”

Section: Discussionmentioning

confidence: 99%

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background More than half of people who use antipsychotic medication for psychosis report having sexual dysfunction. The REMEDY trial aimed to find out if switching antipsychotic medication provides an effective way to reduce sexual dysfunction among people with psychosis. We set out to recruit 216 participants over a two-year period, but recruitment was stopped after an extended 12-month pilot phase, during which we recruited only 10 participants. As part of a nested process evaluation, we conducted qualitative interviews with front-line clinicians to examine barriers to recruitment to the trial. Methods We developed a semi-structured interview schedule to explore staff views on factors that influenced whether they referred potential participants to the study. We interviewed a purposive sample of 51 staff from four National Health Service (NHS) Trusts in England, ensuring a range of different backgrounds, seniority, and levels of involvement in the trial. Audio recordings of interviews were transcribed for verbatim, and data were analysed using an inductive approach to thematic analysis. Results Nine interconnected themes were generated. Six themes concerned barriers to recruitment; including; prioritising patients’ mental stability, mutual discomfort and embarrassment about discussing a “taboo” subject, and concerns about unintended consequences of asking people with psychosis about their sexual functioning. Three themes, including the quality of treatment relationships and strategies for opening dialogue suggested ways to improve recognition of these “hidden” side effects. Conclusion The identification and management of sexual dysfunction among people with psychosis are not priorities for mental health services in England at this time. Many staff working in front-line services feel unprepared and uncomfortable asking people with psychosis about these problems. While greater use of screening tools may improve the identification of sexual dysfunction among people with psychosis, the evaluation and implementation of interventions to manage them will continue to be challenging unless NHS leaders and senior clinicians demonstrate greater commitment to changing current clinical practice. Trial registration Current Controlled Trials ISRCTN12307891.

show abstract

Section: Discussionmentioning

confidence: 99%

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…20 Importantly, UK initiatives monitored by the National Clinical Audit of Psychosis have overall found modest improvements in the health of individuals under the care of early-intervention services in the past 10 years. 21 Our findings suggest that a broader scope of interventions to improve physical health might be necessary.…”

Section: Discussionmentioning

confidence: 83%

The temporal relationship between severe mental illness diagnosis and chronic physical comorbidity: a UK primary care cohort study of disease burden over 10 years

Launders

Kirsh

Osborn

et al. 2022

The Lancet Psychiatry

View full text Add to dashboard Cite

Physical Health Checks and Follow‐Up Care in Deprived and Ethnically Diverse People With Severe Mental Illness: Co‐Designed Recommendations for Better Care

Joury,

Beveridge,

Littlejohns

et al. 2024

Health Expectations

View full text Add to dashboard Cite

BackgroundThere is wide variation in premature mortality rates in adults with severe mental illness (SMI) across London, with Tower Hamlets (a highly deprived and ethnically diverse area) scoring the highest.ObjectiveTo identify examples of best practice and co‐design recommendations for improving physical health checks and follow‐up care amongst people with SMI in Tower Hamlets.MethodsData were collected through online questionnaires (using SMI physical health best practice checklists), one‐on‐one interviews (n = 7) and focus groups (n = 3) with general practices, secondary mental health services, commissioners and leads of community services and public health programmes, experts by experience and community, voluntary and social enterprise organisations in Tower Hamlets. Data were analysed using deductive and inductive thematic analysis.ResultsTwenty‐two participants representing 15 general practices (out of 32), secondary mental health services, commissioners and public health leads completed the online questionnaires. Twenty‐one participants took part in interviews and focus groups. Examples of best practice included cleaning and validating the SMI register regularly by general practices, knowing the number of patients who had been offered and/or received physical health checks, having clear pathways to community and specialist care services, using various communication methods and having a key performance indicator (KPI) for tailored smoking cessation services for people with SMI. Recommendations included adopting evidence‐informed frameworks for risk stratification and utilising the wider primary care workforce with specific training to follow up on results, offer interventions and support navigating pathways and taking up follow‐up care. Incentivising schemes were needed to deliver additional physical health check components such as oral health, cancer screening, Covid‐19 vaccination and sexual health checks. Including KPIs in other community services' specifications with reference to SMI people was warranted. Further engagement with experts by experience and staff training were needed.ConclusionThe present initiative identified best practice examples and co‐designed recommendations for improving physical health checks and follow‐up care in deprived and ethnically diverse people with SMI.Patient or Public ContributionThis initiative was supported by three experts with experience, and two community organisations, who were involved in data curation and interpretation, development of recommendations and/or dissemination activities including writing this manuscript.

show abstract

Examining the effects of national initiatives to improve the physical health of people with psychosis in England: secondary analysis of data from the National Clinical Audit of Psychosis

Cited by 3 publications

References 41 publications

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial

Barriers to the management of sexual dysfunction among people with psychosis: analysis of qualitative data from the REMEDY trial

The temporal relationship between severe mental illness diagnosis and chronic physical comorbidity: a UK primary care cohort study of disease burden over 10 years

Physical Health Checks and Follow‐Up Care in Deprived and Ethnically Diverse People With Severe Mental Illness: Co‐Designed Recommendations for Better Care

Contact Info

Product

Resources

About