A study led by Professor David Osborn in the University College London (UCL) Division of Psychiatry has been published in the Lancet Psychiatry. The study developed a new intervention to reduce cardiovascular disease risk factors for people with severe mental illnesses (SMI), and tested this new intervention against routine General Practice care.

People with SMI, such as schizophrenia, bipolar disorder, or psychosis, have a well-established increased risk of morbidity and mortality from cardiovascular disease. Although the study found similar cardiovascular outcomes in both the Primrose intervention group and routine care, the new intervention was associated with fewer psychiatric admissions and therefore lower costs.

The study was funded by a National Institute for Health Research Programme Grant for Applied Research (NIHR PGfAR) and included researchers from the University College London, University of Southampton, Kings College London, Imperial College London, Camden and Islington NHS Foundation Trust and The McPin Foundation.

Researchers ran a cluster randomised controlled trial with 327 participants across 76 general practices in England recruited through the Clinical Research Networks (CRNs). The participants, aged 30–75 years old, had SMI, raised cholesterol and one or more modifiable cardiovascular disease risk factors. 38 general practices, including 155 patients, were randomly assigned to the Primrose intervention and 38 general practices, including 172 patients were randomised to routine care.

In the West Midlands, 18/76 GP practices and 56/326 patients were recruited.

Participants receiving the Primrose intervention had up to 12 appointments over six months from a trained primary care professional. They received manualised interventions for cardiovascular disease prevention, including adhering to statins; improving diet; increasing physical activity; quitting smoking; or reducing alcohol. The participants allocated to routine care received feedback on screening results and usual care from their GP practice.

Researchers found that total cholesterol concentration at 12 months went down in both the intervention and routine care groups and did not differ between the two groups. This could be due to good care in the treatment as usual group; short duration of the intervention; or low prescribing rates of statins. They also found a reduction in psychiatric hospital admissions and lower service costs in the Primrose group. However, they cannot conclude that the primary care intervention is more effective than routine care in reducing cardiovascular disease risk.

People with SMI are still experiencing an increased risk of morbidity and mortality from cardiovascular disease compared to the general population, so there is a vital need to continue to find and offer effective treatments to this group of people.

For further information please see our website: www.ucl.ac.uk/primrose or follow Primrose on Twitter: @UCLPrimrose