Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study

Abstract Background People with serious mental illness (SMI) have poorer physical health and reduced lifespans compared to the general population. Reasons for this are complex, but one important area is the identification and treatment of physical health conditions. In England, services are structur...

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Main Authors: Julie Williams, Nick Sevdalis, Fiona Gaughran
Format: Article
Language:English
Published: BMC 2019-01-01
Series:Pilot and Feasibility Studies
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40814-019-0396-7
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author Julie Williams
Nick Sevdalis
Fiona Gaughran
author_facet Julie Williams
Nick Sevdalis
Fiona Gaughran
author_sort Julie Williams
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description Abstract Background People with serious mental illness (SMI) have poorer physical health and reduced lifespans compared to the general population. Reasons for this are complex, but one important area is the identification and treatment of physical health conditions. In England, services are structured into primary and secondary care; physical and mental secondary health services are separate. This often leads to a lack of co-ordination of care, with people missing the screening and treatment they need. People with SMI may find accessing physical health services more difficult due to the impact of their symptoms and/or a lack of social support. When they do access physical care, there may be ‘diagnostic overshadowing’ where physical health concerns are put down to a mental health diagnosis. Creating tools to support people with SMI to assume more control of their physical health may help to ameliorate some of these problems. The aim of this study is to evaluate the use of a service user-held Physical health plan (PHP) for secondary mental health service users to determine whether its use increases uptake of physical health services. Methods We will undertake a pilot quality improvement (QI) study to test the use of the PHP. The development of the PHP is described. A Theory of Change (ToC) has been developed which we will test to understand how the PHP is used, using focus groups at the beginning of the study. We will then pilot the use of the PHP for 6 months in two community mental health teams to find out how people use it, what actions are taken, and if it increases uptake of physical health care. We will use the RE-AIM implementation framework to guide the evaluation. After the pilot, we will undertake interviews with service users and clinical staff to elicit their views on using the PHP. Discussion This study uses QI methodology and an implementation framework to test a novel intervention for people with SMI. If successful, the intervention will support people with SMI to access physical health services. The study will inform the design of a larger-scale definitive RCT. Trial registration ClinicalTrials.gov Identifier: NCT03178279. Registered date: 05/06/2017
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spelling doaj.art-64e5539458e442feb3587070a339bda92022-12-21T23:40:48ZengBMCPilot and Feasibility Studies2055-57842019-01-01511910.1186/s40814-019-0396-7Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement studyJulie Williams0Nick Sevdalis1Fiona Gaughran2Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonCentre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonPsychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract Background People with serious mental illness (SMI) have poorer physical health and reduced lifespans compared to the general population. Reasons for this are complex, but one important area is the identification and treatment of physical health conditions. In England, services are structured into primary and secondary care; physical and mental secondary health services are separate. This often leads to a lack of co-ordination of care, with people missing the screening and treatment they need. People with SMI may find accessing physical health services more difficult due to the impact of their symptoms and/or a lack of social support. When they do access physical care, there may be ‘diagnostic overshadowing’ where physical health concerns are put down to a mental health diagnosis. Creating tools to support people with SMI to assume more control of their physical health may help to ameliorate some of these problems. The aim of this study is to evaluate the use of a service user-held Physical health plan (PHP) for secondary mental health service users to determine whether its use increases uptake of physical health services. Methods We will undertake a pilot quality improvement (QI) study to test the use of the PHP. The development of the PHP is described. A Theory of Change (ToC) has been developed which we will test to understand how the PHP is used, using focus groups at the beginning of the study. We will then pilot the use of the PHP for 6 months in two community mental health teams to find out how people use it, what actions are taken, and if it increases uptake of physical health care. We will use the RE-AIM implementation framework to guide the evaluation. After the pilot, we will undertake interviews with service users and clinical staff to elicit their views on using the PHP. Discussion This study uses QI methodology and an implementation framework to test a novel intervention for people with SMI. If successful, the intervention will support people with SMI to access physical health services. The study will inform the design of a larger-scale definitive RCT. Trial registration ClinicalTrials.gov Identifier: NCT03178279. Registered date: 05/06/2017http://link.springer.com/article/10.1186/s40814-019-0396-7Psychotic disordersMental health servicesQuality improvementPhysical health
spellingShingle Julie Williams
Nick Sevdalis
Fiona Gaughran
Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
Pilot and Feasibility Studies
Psychotic disorders
Mental health services
Quality improvement
Physical health
title Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
title_full Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
title_fullStr Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
title_full_unstemmed Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
title_short Evaluation of a Physical health plan for people with psychosis: a protocol for a quality improvement study
title_sort evaluation of a physical health plan for people with psychosis a protocol for a quality improvement study
topic Psychotic disorders
Mental health services
Quality improvement
Physical health
url http://link.springer.com/article/10.1186/s40814-019-0396-7
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