The Effectiveness of Lifestyle Interventions to Reduce Cardiovascular Risk in Patients with Severe Mental Disorders: Meta-Analysis of Intervention Studies

Fernández-San-Martín, Maria Isabel; Martín-López, Luis Miguel; Masa-Font, Roser; Olona-Tabueña, Noemí; Roman, Yuani M.; Martín-Royo, Jaume; Oller-Canet, Silvia; González-Tejón, Susana; San-Emeterio, L.; Barroso-Garcia, Albert; Viñas-Cabrera, Lidia; Flores-Mateo, Gemma

doi:10.1007/s10597-013-9614-6

Cited by 56 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our finding of significant weight reduction among the shorter duration (≤ 6-months) lifestyle interventions is consistent with prior systematic reviews and meta-analyses [19,20]. Importantly, we were able to expand on these prior reviews by including several recently published reports of large-scale trials of longer duration lifestyle interventions.…”

Section: Discussionsupporting

confidence: 87%

Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

Naslund

Whiteman

McHugo

et al. 2017

General Hospital Psychiatry

135

104

View full text Add to dashboard Cite

Objective To conduct a systematic review and meta-analysis to estimate effects of lifestyle intervention participation on weight reduction among overweight and obese adults with serious mental illness. Method We systematically searched electronic databases for randomized controlled trials comparing lifestyle interventions with other interventions or usual care controls in overweight and obese adults with serious mental illness, including schizophrenia spectrum or mood disorders. Included studies reported change in weight [kg] or body mass index (BMI) [kg/m2] from baseline to follow-up. Standardized mean differences (SMD) were calculated for change in weight from baseline between intervention and control groups. Results Seventeen studies met inclusion criteria (1968 participants; 50% male; 66% schizophrenia spectrum disorders). Studies were grouped by intervention duration (≤ 6-months or ≥ 12-months). Lifestyle interventions of ≤ 6-months duration showed greater weight reduction compared with controls as indicated by effect size for weight change from baseline (SMD = − 0.20; 95% CI = − 0.34, − 0.05; 10 studies), but high statistical heterogeneity (I2 = 90%). Lifestyle interventions of ≥ 12-months duration also showed greater weight reduction compared with controls (SMD = − 0.24; 95% CI = − 0.36, − 0.12; 6 studies) with low statistical heterogeneity (I2 = 0%). Conclusion Lifestyle interventions appear effective for treating overweight and obesity among people with serious mental illness. Interventions of ≥ 12-months duration compared to ≤ 6-months duration appear to achieve more consistent outcomes, though effect sizes are similar for both shorter and longer duration interventions.

show abstract

Section: Discussionsupporting

confidence: 87%

Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

Naslund

Whiteman

McHugo

et al. 2017

General Hospital Psychiatry

135

104

View full text Add to dashboard Cite

show abstract

“…This prevented us from evaluating how exercise can work in synergy with other health behaviours, such as diet. Although we found no effect on BMI, other reviews have found that exercise does stimulate weight loss in schizophrenia when used alongside dietary advice (National Institute for Health and Care Excellence, 2014), while interventions that focus solely on diet or physical activity alone are unsuccessful for reducing body weight (Bonfioli et al 2012;Fernández-San-Martín et al 2014).…”

Section: Limitations and Future Researchcontrasting

confidence: 76%

A systematic review and meta-analysis of exercise interventions in schizophrenia patients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…It is well-established that modest improvements in glycated haemoglobin (HbA 1c ) and blood glucose levels can avoid onset of diabetes and have a significant impact on preventing diabetic complications in the general population [11]. A few reviews have investigated the effect of pharmacological [6, 12] and behavioural [7, 8, 13] interventions on these glycaemic measurements in people with SMI. An older review investigated both pharmacological and behavioural interventions [14].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis

et al. 2017

View full text Add to dashboard Cite

People with severe mental illness (SMI) have reduced life expectancy compared with the general population, which can be explained partly by their increased risk of diabetes. We conducted a meta-analysis to determine the clinical effectiveness of pharmacological and non-pharmacological interventions for improving glycaemic control in people with SMI (PROSPERO registration: CRD42015015558). A systematic literature search was performed on 30/10/2015 to identify randomised controlled trials (RCTs) in adults with SMI, with or without a diagnosis of diabetes that measured fasting blood glucose or glycated haemoglobin (HbA1c). Screening and data extraction were carried out independently by two reviewers. We used random effects meta-analysis to estimate effectiveness, and subgroup analysis and univariate meta-regression to explore heterogeneity. The Cochrane Collaboration’s tool was used to assess risk of bias. We found 54 eligible RCTs in 4,392 adults (40 pharmacological, 13 behavioural, one mixed intervention). Data for meta-analysis were available from 48 RCTs (n = 4052). Both pharmacological (mean difference (MD), -0.11mmol/L; 95% confidence interval (CI), [-0.19, -0.02], p = 0.02, n = 2536) and behavioural interventions (MD, -0.28mmol//L; 95% CI, [-0.43, -0.12], p<0.001, n = 956) were effective in lowering fasting glucose, but not HbA1c (pharmacological MD, -0.03%; 95% CI, [-0.12, 0.06], p = 0.52, n = 1515; behavioural MD, 0.18%; 95% CI, [-0.07, 0.42], p = 0.16, n = 140) compared with usual care or placebo. In subgroup analysis of pharmacological interventions, metformin and antipsychotic switching strategies improved HbA1c. Behavioural interventions of longer duration and those including repeated physical activity had greater effects on fasting glucose than those without these characteristics. Baseline levels of fasting glucose explained some of the heterogeneity in behavioural interventions but not in pharmacological interventions. Although the strength of the evidence is limited by inadequate trial design and reporting and significant heterogeneity, there is some evidence that behavioural interventions, antipsychotic switching, and metformin can lead to clinically important improvements in glycaemic measurements in adults with SMI.

show abstract

The Effectiveness of Lifestyle Interventions to Reduce Cardiovascular Risk in Patients with Severe Mental Disorders: Meta-Analysis of Intervention Studies

Cited by 56 publications

References 35 publications

Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

A systematic review and meta-analysis of exercise interventions in schizophrenia patients

The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About