Brenda Happell1, Jackie Curtis2, Michelle Banfield3, John Goss4, Theophile Niyonsenga4, Andrew Watkins5, Chris Platania-Phung6, Lynelle Moon7, Philip Batterham8, Brett Scholz9, Vanessa Prescott10, Robert Stanton11. 1. School of Nursing and Midwifery, University of Newcastle University Drive Callaghan New South Wales, 2308, Australia. Electronic address: Brenda.happell@newcastle.com. 2. Youth Mental Health, South Eastern Sydney Local Health District and Conjoint Senior Lecturer, University of New South Wales, Australia. Electronic address: Jackie.Curtis@health.nsw.gov.au. 3. Head, ACACIA: The ACT Consumer & Carer Mental Health Research Unit, Centre for Mental Health Australian National University, Australia. Electronic address: Michelle.banfield@anu.edu.au. 4. UC Health Research Institute, University of Canberra, Australia. Electronic address: John.Goss@canberra.edu.au. 5. Co-clinical lead - Keeping the Body in Mind Program, NSW Health, Australia. Electronic address: Andrew.Watkins@health.nsw.gov.au. 6. School of Nursing and Midwifery, University of Newcastle University Drive Callaghan New South Wales, 2308, Australia. 7. Head, Health Group, Australian Institute for Health and Welfare, Australia. Electronic address: Lynnelle.Moon@aihw.gov.au. 8. Centre for Mental Health Research, Research School of Population Health, Australian National University, Australia. Electronic address: Philip.Batterham@anu.edu.au. 9. ANU Medical School, College of Health and Medicine, The Australian National University, Australia. Electronic address: brett.scholz@anu.edu.au. 10. Senior Data analyst/project manager, Australian Institute of Health and Welfare, Australia. Electronic address: Vanessa.prescott@aihw.gov.au. 11. Research Cluster Leader - Muscular and Skeletal Health, School of Health, Medical and Applied Sciences, Central Queensland University, Australia. Electronic address: r.stanton@cqu.edu.au.
Abstract
BACKGROUND: Over 690,000 Australians experience psychosis annually, significantly impacting cardiometabolic illness and healthcare costs. Current models of care are fragmented and a critical implementation gap exists regarding the delivery of coordinated physical healthcare for Australians with psychosis. OBJECTIVES: To describe a trial implementing a Physical Health Nurse Consultant (PHNC) role to coordinate physical health care in a community mental health setting. DESIGN/ METHODS: In this 24-month, 2-group randomised controlled trial, 160 adults with psychosis will be randomised to usual care, or to the PHNC in addition to usual care. Using the Positive Cardiometabolic Health treatment framework and working in collaborative partnerships with consumers (consumer-led co-design), the PHNC will provide care coordination including referral to appropriate programmes or services based on the treatment framework, with the consumer. Burden of Disease risk factors will be collected according to Australian Bureau of Statistics' National Health Survey guidelines. Consumer experience will be assessed using the 'Access', 'Acceptability' and 'Shared Decision Making' dimensions of the Patient Experiences in Primary Healthcare Survey. Cost-effectiveness will be modelled from Burden of Disease data using the Assessing Cost Effectiveness Prevention methodology. RESULTS: Data collection of two years duration will commence in late 2018. Preliminary findings are expected in December 2019. Primary outcomes will be the effect of the PHNC role on physical healthcare in community-based adults with psychosis. CONCLUSIONS: The PHNC is an innovative approach to physical health care for adults with psychosis which aims to meet the physical health needs of consumers by addressing barriers to physical health care.
RCT Entities:
BACKGROUND: Over 690,000 Australians experience psychosis annually, significantly impacting cardiometabolic illness and healthcare costs. Current models of care are fragmented and a critical implementation gap exists regarding the delivery of coordinated physical healthcare for Australians with psychosis. OBJECTIVES: To describe a trial implementing a Physical Health Nurse Consultant (PHNC) role to coordinate physical health care in a community mental health setting. DESIGN/ METHODS: In this 24-month, 2-group randomised controlled trial, 160 adults with psychosis will be randomised to usual care, or to the PHNC in addition to usual care. Using the Positive Cardiometabolic Health treatment framework and working in collaborative partnerships with consumers (consumer-led co-design), the PHNC will provide care coordination including referral to appropriate programmes or services based on the treatment framework, with the consumer. Burden of Disease risk factors will be collected according to Australian Bureau of Statistics' National Health Survey guidelines. Consumer experience will be assessed using the 'Access', 'Acceptability' and 'Shared Decision Making' dimensions of the Patient Experiences in Primary Healthcare Survey. Cost-effectiveness will be modelled from Burden of Disease data using the Assessing Cost Effectiveness Prevention methodology. RESULTS: Data collection of two years duration will commence in late 2018. Preliminary findings are expected in December 2019. Primary outcomes will be the effect of the PHNC role on physical healthcare in community-based adults with psychosis. CONCLUSIONS: The PHNC is an innovative approach to physical health care for adults with psychosis which aims to meet the physical health needs of consumers by addressing barriers to physical health care.