HEAD-MIP - HEAlth Dialogue for patients with Mental Illness in Primary care

Background Patients with mental illness have an increased risk of cardiovascular morbidity and mortality. Targeted health conversations can identify individuals at risk and then offer help reducing the risk of disease and complications. The Swedish-developed Health Dialogue is a health conversation including a pedagogical tool to visualize the parts of the patient's lifestyle that might benefit most from improvements. Its use in primary health care has shown improvement of lifestyle habits as well as reduced mortality. Despite a higher expected benefit for patients with mental illness, the Health Dialogue is not aimed specifically or tested for this patient group. Methods Patients > 18 years old seeking primary care for mental illness (depression, anxiety, sleep disorders, or stress-related problems) were included. A trained nurse performed a Health Dialogue with the patients, including both questionnaires of lifestyle habits, stress, mental illness, and measurements of body mass index, blood pressure, blood glucose, and cholesterol. Individually tailored advice based on the risk profile was provided. Results All participants had at least one lifestyle area with an increased risk level. There were over 20% of the patients who had abnormal fasting glucose values, elevated blood pressure, or cholesterol levels. Three-quarters were overweight or obese. More than 40% had the highest risk level for Waist-Hip-Ratio and high-risk levels in the physical inactivity lifestyle area. Compared to an ongoing population screening of 40-year-olds, we found higher proportions of overweight or obesity, physical inactivity, and elevated blood pressure or glucose values. Conclusion Our results with a large proportion of unhealthy lifestyle habits in patients with mental illness in primary care show the importance of interventions in this patient group with potentially positive effects on improved mental wellbeing and decreased metabolic and cardiovascular risk. Studying a larger cohort with long-term follow-up is highly motivated