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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