Need for Cardiovascular Risk Reduction in Persons With Serious Mental Illness: Design of a Comprehensive Intervention
Need for Cardiovascular Risk Reduction in Persons With Serious Mental Illness: Design of a Comprehensive Intervention
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DOI：
10.3389/fpsyt.2018.00786
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发表时间：
2019-02-08
影响因子：
4.7
通讯作者：
Daumit, Gail L.
中科院分区：
文献类型：
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作者：
Dalcin, Arlene T.;Jerome, Gerald J.;Daumit, Gail L.
严重精神疾病（SMI）患者是心血管疾病（CVD）相关死亡率的高风险人群，其死亡率至少是美国总体死亡率的两倍。潜在可改变的CVD风险行为（吸烟、肥胖、缺乏身体活动、不健康饮食）和风险因素（高血压、糖尿病、血脂异常）在SMI患者中均显著升高。对在专业精神卫生环境中实施综合医疗保健的项目的评估并未显示出对降低CVD风险因素有意义的影响。需要经过严格测试的创新干预措施来解决SMI人群的CVD风险负担。在这篇文章中，我们描述了一个全面的18个月的干预设计，以减少心血管疾病的风险，我们正在研究在一个社区精神卫生组织的精神康复计划的随机临床试验。个人层面的干预包括健康行为指导和护理协调/护理管理，以解决所有七个心血管疾病的风险行为和风险因素，并由健康教练和护士提供。如果成功的话，干预措施可以在目前的综合护理模式中采用，并显着改善SMI患者的身体健康。
Persons with serious mental illness (SMI) comprise a high-risk group for cardiovascular disease (CVD)-relatedmortality with rates at least twice those of the overall US. Potentially modifiable CVD risk behaviors (tobacco smoking, obesity, physical inactivity, unhealthy diet) and risk factors (hypertension, diabetes, dyslipidemia) are all markedly elevated in persons with SMI. Evaluations of programs implementing integrated medical care into specialty mental health settings have not shown meaningful effects on CVD risk factor reduction. Rigorously tested, innovative interventions are needed to address the large burden of CVD risk in populations with SMI. In this article, we describe the design of a comprehensive 18-month intervention to decrease CVD risk that we are studying in a randomized clinical trial in a community mental health organization with psychiatric rehabilitation programs. The individual-level intervention incorporated health behavior coaching and care coordination/ care management to address all seven CVD risk behaviors and risk factors, and is delivered by a health coach and nurse. If successful, the intervention could be adopted within current integrated care models and significantly improve the physical health of persons with SMI.