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April 2011
Monitoring and Management of Cardiometabolic Risk Factors In Schizophrenia - A Global Perspective

Richard Uwakwe, Mehrul Hasnain, Peter Hjorth
For THE MOMACRIS STUDY GROUP

This project is funded by World Psychiatric Association

Background: Cardiovascular risk factors including obesity, glucose metabolism dysregulation, atherogenic dyslipidemia and cigarette smoking are highly prevalent in patients with schizophrenia and contribute to their shortened lifespan. Current strategies have failed to improve the cardio-metabolic care and outcome of patients with schizophrenia.

Aims: To determine whether an integrated mental and physical health care approach involving patients with schizophrenia, their care providers and the health professionals would improve identification, management and outcome of cardio-metabolic risk factors in these patients.

Materials and Methods: The study is an open transcultural naturalistic multicentre intervention investigation. Retrospective, cross sectional and prospective data will be collected across the globe from centres in both developed and Low and Middle Income Countries (LAMIC). The study will examine current practice of cardio-metabolic health management of patients with schizophrenia, compare the attitude of health professionals, patients, and patients’ care providers about adiposity and unhealthy lifestyle, identify the barriers to effective cardio-metabolic care of patients with schizophrenia, offer guidance to health professionals to optimize cardio-metabolic monitoring and care of patients with schizophrenia, and provide group dietary and physical activity counseling to the patients. The study will span over 4 overlapping phases.

Instruments and Measures: Structured questionnaires will be used to collect information from patients, patient care-providers and health care providers. The measures will include: Socio-demographic data, psychiatric history and treatment, anthropometric measures, blood pressure, laboratory tests (cholesterol, triglycerides, HDL/LDL, blood glucose, HbA1c), level of activity, tobacco, drug, and alcohol use. The Clinical Global Impression Scale (CGI) and Health of the Nations Outcome Study (HoNOS) will be used to monitored symptoms and well being.

Outcome Measures: Primary outcome measures will be: 1) change in the cardio-metabolic monitoring and care by health professionals and 2) change in the lifestyle of patients with schizophrenia. Secondary outcome measures will include changes in weight, laboratory values and clinical assessments (CGI and HoNOS) in the patients with schizophrenia.

Statistical Analysis: This will focus on comparison of the base line outcome variables and their subsequent follow up post intervention measurements.  Analytical procedures will be employed to examine association between outcome variables and participant characteristics.

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