Improving Physical Health in Patients With Psychiatric Disorders in General Practice (SOFIA)
- Conditions
- Bipolar DisorderPsychiatric DisorderSchizophreniaSevere Depression
- Interventions
- Other: SOFIA model
- Registration Number
- NCT04618250
- Lead Sponsor
- University of Copenhagen
- Brief Summary
People with a severe mental illness (SMI) have an increased risk for premature mortality, predominantly due somatic health conditions. Evidence indicates that prevention and improved treatment of somatic conditions in patients with SMI could reduce this excess mortality. This paper reports a protocol designed to evaluate the feasibility and acceptability of a coordinated co-produced care programme (SOFIA model) in the general practice setting to reduce mortality and improve quality of life in patients with severe mental illness. The primary outcomes are description of study feasibility (recruitment and retention) and acceptability.
The SOFIA trial is designed as cluster randomized controlled trial targeting general practices in two regions in Denmark. 12 practices will each recruit 15 community-dwelling patients aged 18 and older with severe mental illness (SMI). Practices will be randomized in a ratio 2:1 to deliver a coordinated care program or care-as-usual during a 6 month period. An online randomized algorithm is used to perform randomization. The coordinated care program comprises enhanced educational training of general practitioners and their clinical staff, and prolonged consultations focusing on individual needs and preferences of the patient with SMI. Assessments are administered at baseline, and at end of study period.
If delivery of the intervention in the general practice setting proves feasible, a future definitive trial to determine the effectiveness of the intervention in reducing mortality and improving quality of life in patients with SMI can take place.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 76
- Registered at a general practice situated in the Danish Capital Region or the Region of Zealand;
- Registered at general practice with International Classification of Primary Care version 2 (ICPC-2) diagnostic code p72 (psychotic disorders);
- Registered at general practice with ICPC-2 diagnostic code p73 (bipolar mood disorders);
- Prescription of Lithium (Anatomical Therapeutic Chemical (ATC): N05AN);
- Registered at general practice with ICPC-2 diagnostic code p76 AND (Prescription of Lamotrigine (N03A09) OR Carbamazepine (N03AF01) OR Valproic Acid (N03AG01));
- Registered at general practice with ICPC-2 diagnostic code p76 (unipolar depressive disorders) AND (Prescription of tricyclic antidepressants (N06AA) AND/OR venlafaxine (N06AX16) AND/OR duloxetine (N06AX21) AND/OR Monoamine Oxidase A Inhibitor (MAOi) (N06AG) AND/OR non-selective MAOi (N06AF)).
- Subjected to any type of legal measure as stipulated in the Danish Mental Health Law;
- Registered with a dementia diagnosis ICPC-2 p70 (dementia);
- Receiving end-of-life care;
- Non-Danish speakers;
- Assumed by the patient's general practitioner to have an overall functional level that is too low for meaningful participation in trial.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Coordinated, co-produced health care SOFIA model -
- Primary Outcome Measures
Name Time Method Effectiveness of the collecting EQ5D-5L questionnaires 6 months after randomization Proportion of returned and completed EQ5D-5L questionnaire.
Effectiveness of the design in terms of recruitment of practices and patients 6 months after randomization Proportion of contacted general practices, which agree to participate in the study and the eligibility and consent rate of patients.
Acceptability of the intervention for patients and general practitioners, staff and patients. Entire study period (6 months) Qualitative semi-structured interviews with patients and general practitioners, staff and patients.
Effectiveness of the collecting Multimorbidity Questionnaires 6 months after randomization Proportion of returned and completed Multimorbidity Questionnaires.
Retention of patients during the study 6 months after randomization Proportion of recruited patients in the intervention group who attend the first consultation.
Acceptability of REDcap software for general practitioners Entire study period (6 months) Qualitative semi-structured interviews with general practitioners.
Mortality 6 months after randomization Number of all-cause deaths of participants during the 6 month trial period.
Hospitalizations 6 months after randomization Number of all-cause in- and outpatient hospitalizations of participants during the 6 months trial period.
- Secondary Outcome Measures
Name Time Method Multimorbidity Questionnaires (MMQ) scores 3 times during study period (at baseline, before prolonged consultation and 6 months after randomization Scores on Multimorbidity Questionnaire
Trial Locations
- Locations (1)
University of Copenhagen
🇩🇰Copenhagen, Denmark