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Table 1 Characteristics of studies including patients

From: Barriers to monitoring and management of cardiovascular and metabolic health of patients prescribed antipsychotic drugs: a systematic review

Study ID & Country

Aim

Design

Data collection method

Setting

Sample size

Participants

Mental health diagnosis

Proportion of patients prescribed antipsychotic drugs

Information on the use of antipsychotic by patients

Johnstone, 2009;UK [29]

To investigate the barriers to uptake of and adherence to physical activity in community dwelling patients with a diagnosis of schizophrenia

Qualitative study

Semi-structured interviews

Community mental health services

27 community dwelling patients with a diagnosis of schizophrenia

Patients with mental illness

Patients with diagnosis of schizophrenia for a minimum of 1 year

100%

Second generation antipsychotic 52%

Clozapine 44%

First generation antipsychotic 4%

Rastad, 2014; Sweden [17]

To study the perception and experience of barriers to and incentives for physical activity in daily living in patients with schizophrenia, as reported by the patients themselves.

Qualitative exploratory study

Semi-structured interviews

Multicentre (3 psychiatric outpatient clinics)

20 patients with schizophrenia or schizoactive disorder

Patients with mental health conditions

Patients with schizophrenia or schizoactive disorder

100%

No data available on the type of antipsychotics

Vandyk, 2012; Canada [24]

To explore the subjective experience of weight and lifestyle from the perspective of people with schizophrenia

Qualitative study within constructivism paradigm

Interview

Outpatient clinic at psychotic hospital

19 patients diagnosed with schizophrenia or schizoactive disorder

Patients with mental health conditions

Schizophrenia or schizoactive disorders

100%

Atypical antipsychotics100%, conventional antipsychotics 39%

Blixen, 2016;USA [12]

To assess perceived barriers to self-management among patients with both SMI and DM in order to inform healthcare delivery practices

Exploratory, observational and phenomenological approach

Interview: semi-structured

Urban safety net clinic

20 subjects with severe mental conditions

Patients with severe mental illness

schizophrenia, schizoactive disorder, bipolar disorder or major depression

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Graham, 2014; Canada [16]

To potentially enhance health initiatives by exploring facilitators that help mental health service users engage in better health behaviours and the types of health programs mental health service users want to develop

Qualitative study

Focus group interviews (5 groups)

Psychosocial rehabilitation centre

37 mental health service users

Patients with mental health conditions

Broad range of mental conditions (Schizophrenia, bipolar related disorders, depressive disorders, anxiety disorders, obsessive-compulsive disorders)

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Kristiansen,2015; Denmark [14]

To explore physical health problems and their causes in patients with severe mental illness, as well as possibilities for prevention and treatment from the patients’ and staff’s perspectives

Qualitative study

Focus group interviews (6 groups)

3 outpatients clinics

33 participants: staff: n = 19 and patients: n = 14.

Mental health care staff and patients with mental health conditions

Patients with schizophrenia or substance abuse

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

McDevitt, 2006;USA [30]

To explore perceived barriers and benefits to physical activity in people with serious and persistent mental illness (SPMI) who were enrolled in community-based psychiatric rehabilitation.

Qualitative exploratory study

Focus group interviews (4 groups)

2 community based psychiatric rehabilitation centres

34 participants

Patients with mental health conditions undergoing community based psychiatric rehabilitation

No specific information regarding the diagnosis of mental conditions

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Pearsal, 2014; UK [18]

To examine the attitudes, views, and experiences of patients who had declined to participate in a healthy living programme

A qualitative study using grounded theory

Interview

Community mental health services

30 patients with a diagnosis of schizophrenia, schizoaffective or bipolar affective disorder

Patients with mental health conditions declined to take part in a healthy living programme based in a community mental health team

Patients with

schizophrenia, schizoaffective or bipolar affective disorder

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Pitman, 2011; UK [26]

To assess current practice and attitudes related to screening and reduction in risk factors for cardiovascular disease, preferences for service provision, and perceived barriers to service uptake.

Cross sectional study

Survey

Community psychiatric services

227 service users, 143 primary care staff, and 166 community mental health team (CMHT) Staff.

Mental health care staff and patients with mental health conditions

Patients with wide range of mental conditions (Schizophrenia, bipolar disorder, depression and anxiety)

Not reported

No specific information regarding the type of antipsychotic drug use however participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Yarboroug,2011;USA [27]

To adapt a successful lifestyle/weight loss intervention for this population, deliver it in mental health clinics, and concurrently measure implementation factors

Mixed methods: Qualitative interviews with intervention observation sessions

Interview

Two public mental health clinics

Control group (N = 32)

Intervention group (N = 16)

Patients with mental health conditions

No specific information regarding the diagnosis of mental conditions

Not reported

Report mentions that patients should be stable on antipsychotic therapy ≥30 days, but no specific information regarding type of antipsychotics; Participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Yarboroug, 2016; Portland [13]

To identify modifiable factors associated with making and maintaining healthy lifestyle changes in order to inform clinicians and improve the development of future interventions for individuals with serious mental illnesses

Mixed methods: Qualitative interviews with intervention observation sessions

Interview

Multicentre (unclear)

84 participants

Patients with mental health conditions

No specific information regarding the diagnosis of mental conditions

Not reported

Report mentions that all patients should be stable on antipsychotic therapy ≥30 days, but no specific information regarding type of antipsychotics; participants described barriers to monitoring and management of cardiovascular and metabolic side effects

Wärdig, 2015; Sweden [15]

To describe how persons with psychosis perceive participation in a lifestyle intervention, and use these perceptions to present factors to for consideration in future interventions

Qualitative, phenomenological approach

Interview: semi-structured

Psychiatric outpatient care

40 participants with psychosis

Patients with severe mental illness

Patients diagnosed with psychosis

Not reported

The participants were on outpatient care with diagnosed psychosis and medicines use