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HEAlth Dialogues for Patients With Mental Illness in Primary Care (HEAD-MIP)

Primary Purpose

Mental Illness, Stress, Fatigue

Status
Recruiting
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
health dialogue
Sponsored by
Region Skane
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Mental Illness focused on measuring primary health care, health dialogue, long-term follow-up, mental illness

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • patients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders or stress related problems

Exclusion Criteria:

  • Dementia, not speaking, writing or understanding spoken the Swedish language.

Sites / Locations

  • Peter NymbergRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Health dialogue

Arm Description

Patients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders or stress related problems) will be followed at 12 and 24 months from baseline in a first assessment, and after 5 and 10 years with follow-up in national registers in a later phase. The patient will fill out a web-based questionnaire about lifestyle habits before the visit to the health center and will be called for blood sampling and measurement of blood pressure and BMI. A nurse with special training in the Health Dialogue then meets the patient and provides individually tailored advice based on the patient's unique conditions and the risk profile on the Health Dialogue, such as help with smoking cessation, physical activity on prescription (PaR-S), contact with a dietitian, physiotherapist. A continued contact with a psychologist or physician will be planned if necessary

Outcomes

Primary Outcome Measures

Proportion of patients who change their risk profile
Proportion of patients who achieve a change in the risk profile on the Health Dialogue. A positive change ("yes") is defined if a larger number of the variables on the Health Curve have improved than deteriorated. "No" is defined as no change or negative change has taken place.

Secondary Outcome Measures

Self reported risk change
Proportion of patients who had change between baseline and follow-up in self-reported lifestyle risk assessment
Proportion of smokers and number of cigarettes per day
Proportion of patients, self-reported answers about smoking, Yes (number of cigarettes per day) no, or former
Referral to smoking cessation
Proportion of patients who have undergone smoking cessation
Time and intensity in physical activity
Proportion of patients in number of minutes self-reported in physical activity per week in different intensity
Referral PaR-S
Proportion of patients who have received PaR-S
Referral physiotherapist
Proportion of patients who have received referral to physiotherapist
Alcohol consumption
Proportion of patients, self-reported number of glasses with 4 cl 40% alcohol per week
Metabolic markers
Overnight fasting venous blood sampling. Change in mmol/L from baseline to follow-up of metabolic markers; total cholesterol, triglycerides, high density lipids (HDL), and low density lipids (LDL)
Referral dietitian
Proportion of patients who have received referral to dietitian
Proportion lost to follow-up
Proportion of dropouts / missed follow-ups
Proportion of patients affected with type 2 diabetes
Long time follow-up in registers. Proportion of patients affected of type 2 diabetes: Diagnosis and date of onset of type 2 diabetes mellitus (ICD 10: E11).
Proportion of patients affected with myocardial infarction
Long time follow-up in registers. Proportion of patients affected with myocardial infarction: Diagnosis and date of onset of myocardial infarction (MI) (I21)
Proportion of patients affected with ischemic stroke
Long time follow-up in registers. Proportion of patients affected of ischemic stroke: Diagnosis and date of onset of ischemic stroke (I63)
Proportion of deaths
Long time follow-up in registers. Proportion of patients. Diagnosis and date of death
Proportion of cardiovascular death
Long time follow-up in registers. Proportion of patients affected of cardiovascular death: Diagnosis and date of onset of death, cardiovascular death (ICD 10: I)
Proportion of patients affected with venous thromboembolism
Long time follow-up in registers. Proportion of patients affected of : Diagnosis and date of onset of venous thromboembolism (I82.0-I82.3, I82.8, I82.9 & I82.8W)
Proportion of patients affected by MACE (Myocardial infarction, stroke or cardiovascular death)
Long time follow-up in registers. Proportion of patients affected of Myocardial infarction, stroke or cardiovascular death (MACE) up to 20 years from baseline: Diagnosis and date of first onset of ischemic stroke (I63), death, cardiovascular death (ICD 10: I), combined to the composite outcome measure MACE (MI, stroke or cardiovascular death).
Co-peptin
Measured at baseline in pmol/L. Blood sampling after overnight fasting.
Blood glucose
Fasting blood glucose from venous blood sampling in mmol/L
BMI
BMI (weight and height will be combined to report BMI in kg/m^2)
Waist hip ratio (WHR)
WHR will be calculated by the ratio between waist in cm and and hip in cm
Blood pressure
Measured (mmHg), sitting at right arm after 10 minutes of resting with both feet on the floor.

Full Information

First Posted
October 31, 2021
Last Updated
January 25, 2023
Sponsor
Region Skane
Collaborators
Lund University
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1. Study Identification

Unique Protocol Identification Number
NCT05181254
Brief Title
HEAlth Dialogues for Patients With Mental Illness in Primary Care
Acronym
HEAD-MIP
Official Title
HEAlth Dialogues for Patients With Mental Illness in Primary Care
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2020 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Region Skane
Collaborators
Lund University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
In the current project, primary health care patients with mental illness such as anxiety, depression, fatigue or sleep disorders will be followed. The study includes both health conversations with the health curve as a systematic work with lifestyle habits, and the biochemical risk marker copeptin with a focus on improved lifestyle habits and the development of cardiovascular complications. Participants will be followed up at 12 and 24 months with renewed health interview including the health curve and blood sampling. National registries will be used for a, up to 20 year long follow-up regarding cardiovascular complications and mortality.
Detailed Description
Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, partly related to unhealthy lifestyle habits. However, not all risk factors for developing cardiovascular disease are known yet. The interest in studies about the importance of copeptin as a biochemical risk factors has increased in recent years. Objectives: The main aim with this project is assessment of the effect of Health Dialogue with the health curve (in swedish; Hälsokurvan) on lifestyle habits and cardiovascular risk factors in patients with mental illness in primary care. The second aim is to assess copeptin's prognostic value and to collect blood samples in a biobank for future research on molecular biomarkers with prognostic value for cardiovascular disease. Work plan: The study has a prospective observational design. The method with Health Dialogues is previously validated in a Swedish context and is based on a detailed lifestyle questionnaire, blood testing and personalized counselling by a trained health care professional. The patients will be followed with a new Health Dialogue and blood samples after 12 and 24 months and for 20 years with National Registers Significance: The effect of Health Dialogues in patients with mental illness is not studied yet. The current fast implementation of the method in the primary care in south of Sweden (the region of Scania) provides a unique opportunity to study this patient group and the expected benefits of Health Dialogues in the long term, to study a potentially useful risk biomarker (copeptin) as well as to build a biobank for future studies on cardiovascular prognostic risk markers.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mental Illness, Stress, Fatigue, Sleep Disorder, Depression, Diabetes, Myocardial Disease, Stroke, Death
Keywords
primary health care, health dialogue, long-term follow-up, mental illness

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
400 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Health dialogue
Arm Type
Experimental
Arm Description
Patients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders or stress related problems) will be followed at 12 and 24 months from baseline in a first assessment, and after 5 and 10 years with follow-up in national registers in a later phase. The patient will fill out a web-based questionnaire about lifestyle habits before the visit to the health center and will be called for blood sampling and measurement of blood pressure and BMI. A nurse with special training in the Health Dialogue then meets the patient and provides individually tailored advice based on the patient's unique conditions and the risk profile on the Health Dialogue, such as help with smoking cessation, physical activity on prescription (PaR-S), contact with a dietitian, physiotherapist. A continued contact with a psychologist or physician will be planned if necessary
Intervention Type
Behavioral
Intervention Name(s)
health dialogue
Other Intervention Name(s)
The health curve
Intervention Description
The visual health assessment formulary is based on detailed questions about food, physical activity, heredity, smoking, alcohol, stress and mental illness and measurements such as BMI, blood pressure and blood fats. Patients fill in a web-based questionnaire resulting in a visual colorful scale showing a risk assessment (Figure 1). The Health Dialogue is a prognostic tool that provides an estimate of the increase in risk with current lifestyle habits. The use has shown improvement of lifestyle habits such as smoking cessation, lower intake of fat and higher physical activity level as well as reduced mortality in a long-term follow-up.
Primary Outcome Measure Information:
Title
Proportion of patients who change their risk profile
Description
Proportion of patients who achieve a change in the risk profile on the Health Dialogue. A positive change ("yes") is defined if a larger number of the variables on the Health Curve have improved than deteriorated. "No" is defined as no change or negative change has taken place.
Time Frame
24 months from baseline
Secondary Outcome Measure Information:
Title
Self reported risk change
Description
Proportion of patients who had change between baseline and follow-up in self-reported lifestyle risk assessment
Time Frame
At 12 and 24 months from baseline
Title
Proportion of smokers and number of cigarettes per day
Description
Proportion of patients, self-reported answers about smoking, Yes (number of cigarettes per day) no, or former
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Referral to smoking cessation
Description
Proportion of patients who have undergone smoking cessation
Time Frame
At 12 and 24 months from baseline
Title
Time and intensity in physical activity
Description
Proportion of patients in number of minutes self-reported in physical activity per week in different intensity
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Referral PaR-S
Description
Proportion of patients who have received PaR-S
Time Frame
At 12 and 24 months from baseline
Title
Referral physiotherapist
Description
Proportion of patients who have received referral to physiotherapist
Time Frame
At 12 and 24 months from baseline
Title
Alcohol consumption
Description
Proportion of patients, self-reported number of glasses with 4 cl 40% alcohol per week
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Metabolic markers
Description
Overnight fasting venous blood sampling. Change in mmol/L from baseline to follow-up of metabolic markers; total cholesterol, triglycerides, high density lipids (HDL), and low density lipids (LDL)
Time Frame
At 12 and 24 months from baseline
Title
Referral dietitian
Description
Proportion of patients who have received referral to dietitian
Time Frame
At 12 and 24 months from baseline
Title
Proportion lost to follow-up
Description
Proportion of dropouts / missed follow-ups
Time Frame
At 12 and 24 months from baseline
Title
Proportion of patients affected with type 2 diabetes
Description
Long time follow-up in registers. Proportion of patients affected of type 2 diabetes: Diagnosis and date of onset of type 2 diabetes mellitus (ICD 10: E11).
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of patients affected with myocardial infarction
Description
Long time follow-up in registers. Proportion of patients affected with myocardial infarction: Diagnosis and date of onset of myocardial infarction (MI) (I21)
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of patients affected with ischemic stroke
Description
Long time follow-up in registers. Proportion of patients affected of ischemic stroke: Diagnosis and date of onset of ischemic stroke (I63)
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of deaths
Description
Long time follow-up in registers. Proportion of patients. Diagnosis and date of death
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of cardiovascular death
Description
Long time follow-up in registers. Proportion of patients affected of cardiovascular death: Diagnosis and date of onset of death, cardiovascular death (ICD 10: I)
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of patients affected with venous thromboembolism
Description
Long time follow-up in registers. Proportion of patients affected of : Diagnosis and date of onset of venous thromboembolism (I82.0-I82.3, I82.8, I82.9 & I82.8W)
Time Frame
From baseline and up to 20 years follow-up
Title
Proportion of patients affected by MACE (Myocardial infarction, stroke or cardiovascular death)
Description
Long time follow-up in registers. Proportion of patients affected of Myocardial infarction, stroke or cardiovascular death (MACE) up to 20 years from baseline: Diagnosis and date of first onset of ischemic stroke (I63), death, cardiovascular death (ICD 10: I), combined to the composite outcome measure MACE (MI, stroke or cardiovascular death).
Time Frame
From baseline and up to 20 years follow-up
Title
Co-peptin
Description
Measured at baseline in pmol/L. Blood sampling after overnight fasting.
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Blood glucose
Description
Fasting blood glucose from venous blood sampling in mmol/L
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
BMI
Description
BMI (weight and height will be combined to report BMI in kg/m^2)
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Waist hip ratio (WHR)
Description
WHR will be calculated by the ratio between waist in cm and and hip in cm
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.
Title
Blood pressure
Description
Measured (mmHg), sitting at right arm after 10 minutes of resting with both feet on the floor.
Time Frame
At baseline and follow-up at 12 and 24 months from baseline.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: patients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders or stress related problems Exclusion Criteria: Dementia, not speaking, writing or understanding spoken the Swedish language.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Veronica Milos Nymberg, PhD
Phone
+46 (0)733565679
Email
veronica.milos_nymberg@med.lu.se
First Name & Middle Initial & Last Name or Official Title & Degree
Peter Nymberg, PhD
Phone
+46 (0) 705759810
Email
peter.nymberg@med.lu.se
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miriam Pikkemaat, PhD
Organizational Affiliation
Lund University/ Region Skane
Official's Role
Study Chair
Facility Information:
Facility Name
Peter Nymberg
City
Helsingborg
State/Province
Region Skane
ZIP/Postal Code
253 62
Country
Sweden
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Nymberg, PhD
Phone
+46 (0)705759810
Email
peter.nymberg@med.lu.se
First Name & Middle Initial & Last Name & Degree
Veronica Milos-Nymberg, PhD
Phone
+46 (0)733 565679
First Name & Middle Initial & Last Name & Degree
Peter Nymberg, PhD
First Name & Middle Initial & Last Name & Degree
Miriam Pikkemaat, PhD
First Name & Middle Initial & Last Name & Degree
Veronica Milos-Nymberg, PhD

12. IPD Sharing Statement

Plan to Share IPD
No
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HEAlth Dialogues for Patients With Mental Illness in Primary Care

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