- FACT teams van GGZ Friesland (Leeuwarden, Drachten, Franeker), GGZ Drenthe (Assen, Emmen, Beilen, Meppel), UCP, Lentis (Winschoten, Uithuizen), Dimence (Almelo, Zwolle)
- UMCG disciplinegroep Epidemiologie
2013 – 2016
- ZonMW (150.000) en matching door deelnemende GGZ-instellingen
Patients with severe mental illness (SMI) have an increased cardiometabolic risk and a reduced life expectancy of 15-20 years. PHAMOUS-screenings show that many SMI outpatients are overweight, have diabetes mellitus type 2, high blood pressure and/or high cholesterol. Lifestyle changes, such as increased exercise, healthier diet and less smoking, have a positive effect on physical health. The aim of LION is to investige the effectiveness of a lifestyle intervention in SMI outpatients. The one-year intervention is based on the stoplight method and uses e-health tools. First, a webtool displays a risk profile with all lifestyle behaviors in green, orange or red, depending on the level of risk. The website-generated lifestyle profile provides insight for patient and nurse. Second, the patient decides which behavior he/she wants to change. The nurses use motivational interviewing techniques and the stages of change model to assist the patient in this process. Third, the Traffic Light is used to create a lifestyle plan, in which patients set their own goals on the chosen lifestyle areas, including what the patient’s needs are to achieve the goals, such as family involvement. The nurse’s role is to support patients in setting realistic goals. Patients can be included if they sign informed consent and fulfill one or more of the following inclusion criteria: waist circumference > 102 cm (m) of > 88 cm (f); BMI > 25 kg/m2; fasting glucose > 5.6 mmmol/l. Nurses are trained in using the webtool and in motivational interviewing. LION is a cluster randomized trial; FACT teams are assigned to the intervention or control condition at random. In the active control condition, nurses discuss PHAMOUS results with patients and provide lifestyle coaching as usual, without the webtool. Measurements are PHAMOUS screenings before the start of the intervention and after 12 months, with a shortened extra measurement after 6 months. Primary outcome measure waist circumference. Secondary outcomes include readiness to change (motivation), weight and height to calculate BMI, and other risk factors including all the components of the metabolic syndrome. These include blood pressure, plasma triglycerides, cholesterol (LDL, HDL, and total cholesterol) and fasting glucose and HbA1c. Furthermore, the measurements include depressive and negative symptoms. Finally, a cost-effectiveness analysis will be performed.