Exploring severe mental illness and diabetes: protocol for a longitudinal observational and qualitative mixed methods study

TY - JOUR

T1 - Exploring severe mental illness and diabetes

T2 - protocol for a longitudinal observational and qualitative mixed methods study

AU - Bellass, Susan

AU - Taylor, Johanna

AU - Han, Lu

AU - Prady, Stephanie Louise

AU - Shiers, David

AU - Jacobs, Rowena

AU - Holt, Richard

AU - Radford, John

AU - Gilbody, Simon

AU - Hewitt, Catherine Elizabeth

AU - Doran, Timothy

AU - Alderson, Sarah L

AU - Siddiqi, Najma

N1 - © Sue Bellass, Johanna Taylor, Lu Han, Stephanie L Prady, David Shiers, Rowena Jacobs, Richard Ian Gregory Holt, John Radford, Simon Gilbody, Catherine Hewitt, Tim Doran, Sarah L Alderson, Najma Siddiqi, 2019

PY - 2019/9/6

Y1 - 2019/9/6

N2 - Background: The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolardisorder is 15-20 years less than for the population as a whole. Diabetes contributes significantly to this inequality, being 2-3times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychoticmedication and unhealthy lifestyles, which often occur in the context of socio-economic disadvantage and healthcare inequality.However, little is known about how these factors interact to influence the risk of developing diabetes and poor diabeticoutcomes, or how the organisation and provision of healthcare may contribute.Objective: The study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people withSMI.Methods: This study will employ a concurrent mixed methods design combining the interrogation of electronic primary carehealth records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI anddiabetes, their relatives/friends, and healthcare staff. The study has been funded for two years, from September 2017 toSeptember 2019 and data collection has recently ended.Results: CPRD and linked health data will be used to explore the association of socio-demographic, illness and healthcarerelated factors with both the development and outcomes of Type 2 diabetes in people with SMI. Experiences of managing thecomorbidity and accessing healthcare will be explored through qualitative interviews using topic guides informed by evidencesynthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions and outcomes for people with SMI. Findings will be translated into recommendations forinterventions and services using co-design workshops.Conclusions: Improving diabetes outcomes for people with SMI is a high priority area nationally and globally. Understandinghow risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessaryfirst step in developing healthcare interventions to improve outcomes for people with diabetes and SMI.

AB - Background: The average life expectancy for people with a severe mental illness (SMI) such as schizophrenia or bipolardisorder is 15-20 years less than for the population as a whole. Diabetes contributes significantly to this inequality, being 2-3times more prevalent in people with SMI. Various risk factors have been implicated, including side effects of antipsychoticmedication and unhealthy lifestyles, which often occur in the context of socio-economic disadvantage and healthcare inequality.However, little is known about how these factors interact to influence the risk of developing diabetes and poor diabeticoutcomes, or how the organisation and provision of healthcare may contribute.Objective: The study aims to identify the determinants of diabetes and to explore variation in diabetes outcomes for people withSMI.Methods: This study will employ a concurrent mixed methods design combining the interrogation of electronic primary carehealth records from the Clinical Practice Research Datalink (CPRD GOLD) with qualitative interviews with adults with SMI anddiabetes, their relatives/friends, and healthcare staff. The study has been funded for two years, from September 2017 toSeptember 2019 and data collection has recently ended.Results: CPRD and linked health data will be used to explore the association of socio-demographic, illness and healthcarerelated factors with both the development and outcomes of Type 2 diabetes in people with SMI. Experiences of managing thecomorbidity and accessing healthcare will be explored through qualitative interviews using topic guides informed by evidencesynthesis and expert consultation. Findings from both datasets will be merged to develop a more comprehensive understanding of diabetes risks, interventions and outcomes for people with SMI. Findings will be translated into recommendations forinterventions and services using co-design workshops.Conclusions: Improving diabetes outcomes for people with SMI is a high priority area nationally and globally. Understandinghow risk factors combine to generate high prevalence of diabetes and poor diabetic outcomes for this population is a necessaryfirst step in developing healthcare interventions to improve outcomes for people with diabetes and SMI.

KW - schizophrenia;

KW - bipolar disorder;

KW - diabetes mellitus;

KW - diabetes complications

UR - https://preprints.jmir.org/preprint/13407

U2 - 10.2196/preprints.13407

DO - 10.2196/preprints.13407

M3 - Article

VL - 8

JO - JMIR Research Protocols

JF - JMIR Research Protocols

IS - 9

M1 - 13407

ER -