Johan Åhlin , Sonja Beckmann, Indre Brasaite Loreena Hill, Victoria Navarta , Eriikka Siirala

1. Self-management intervention to prevent weight gain in young patients with antipsychotic medication Johan Åhlin, Sonja Beckmann, IndreBrasaite Loreena Hill, Victoria Navarta, EriikkaSiirala

2. Background to our project • 80% of patients with psychotic mental illnesses take secondary generation antipsychotic medication (SGA)  high risk for obesityand diabetes • SGA increases costs for the health care system • Schizophrenic patients have 12-fold higher risk for cardiovascular disease, than general population The European Academy of Nursing Science

3. Why our project is important • 15-y reduced life expectancy compared to general population (e.g. CV disease, suicide) • Onset of psychotic mental illness is mainly between the age of 16-25 • Gaps in literature: no evaluation of peer / family support, key characteristics of successful behavioral interventions • Preventive non-pharmacological interventions for weight management can be effective, cost-efficient and beneficial, if they are offered in early stages of antipsychotic treatment. The European Academy of Nursing Science

4. Our Aim To conduct a pilot-test of a 4 component intervention, to control weight as indicator for self-management, in individuals aged of 16 to 25 years prescribed SGA in the past 6 months. • Taking action • Patient / health care provider partnership • Problem solving • Decision making • Resource utilization The European Academy of Nursing Science

5. 4 components of the intervention webBALANCEplatform Interactive internet platform and APP (self-monitoring of energy intake, expenditure, weight, Wii activities … ) Peer support Exercise groups, cooking class, grocery shopping … Booklet with information Illness and comorbidities, side effects of medication, contact numbers, additional links, further education programs, support groups, coping strategies… Individual nurse counseling Weekly face-to-face / telephone contact with patients and family, standardized intervention process, guidelines… The European Academy of Nursing Science

6. Intervention in view of behavior change techniques and self-management support The European Academy of Nursing Science

7. Methods • Design: Single case experimental studies • Sample: purposive, 4 male and 4 female • Inclusion: age 16-25, prescription SGA within the last 6 months, living in community, stable psychiatric state according to diagnosis by psychiatrist • Primary outcome: energy intake/expenditure in kcal/day • Secondary outcomes: weight, BMI, waist circumference, clinical indicators (e.g. glucose, lipids…), adherence to the intervention • Qualitative interviews before and after the intervention The European Academy of Nursing Science

8. Difference in energyintake and expenditure Days

9. Thank you for your attention

10. References • Citrome L ; Vreeland B, (2008) Schizophrenia, obesity, and antipsychotic medications: what can we do? • Eapen V et al (2011) Weight gain and metabolic syndrome among young patients on antipsychotic medication • Humphrey L.B (2008) Obesity in Schizophrenia: Screening, Monitoring, and Health Promotion • McLoughen et al (2012) Physical health & wellbeing • Alvare-Jimenez (2008) • Saravane D, Feve B, Frances Y, Corruble E, Lancon C, Chanson P, Maison P, Terra JL, Azorin JM; avec le soutieninstitutionnel du laboratoire Lilly. Drawing up guidelines for the attendance of physical health of patients with severe mental illness]. Encephale. 2009 Sep;35(4):330-9. • Ward et al (2013) journal of Pharmacy and therapeutics – indicate increasings costs with the medication • Wagner, E. H., Austin, B. T., & Korff, M. V. (1996). Improving Outcomes in Chronic Illness. Managed Care Quarterly, 4, 2, 12-25 • Vandyk & Baker ( 2012) • Morgan & Morgan (2009) Single case research methods for the behavioral and health sciences: London: sage The European Academy of Nursing Science