START TIME 14:50 A realist synthesis of non-pharmacological interventions for antipsychotic-induced weight gain in people with severe mental illness (RESOLVE): incorporating experts-by-experience stakeholders

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

2E.5

Presenter:

Ian Maidment

Twitter:

@birdigk93

Co-authors:

Geoff Wong, Claire Duddy, Hafsah Habib, Katherine Allen, Rachel Upthegrove, Sheri Odula, Amy Ahern, Alex Kenny, Daniel Robotham, Ian Maidment

Author institutions:

Aston University, University of Oxford, Birmingham and Solihull Mental Health NHS Foundation Trust, University of Birmingham, University of Cambridge, University of East Anglia, McPin Foundation

Problem

Antipsychotics are widely used in the treatment of schizophrenia and other severe mental illnesses (SMI). These medications can produce a range of side-effects, one of which is weight gain. Up to 80% of people with schizophrenia or bipolar disorder are overweight or obese. Many different non-pharmacological interventions have been tried to limit antipsychotic-induced weight gain, however there is not a clear picture of what works, for whom and in what circumstances. Thus, a realist approach is ideal for exploring how and why a complex social programme involving human actions and decisions, such as non-pharmacological interventions to manage antipsychotic-induced weight gain, may or may not work, and thus inform the theoretical development of an intervention and practice-based guidance.

Approach

This project will undertake a realist evaluation incorporating secondary and primary data collection inclusive of grey literature and stakeholder engagement from experts-by-experience. An initial programme theory will be developed, setting out how and why outcomes occur within an intervention and is based on the collective experience of the project team with PPI input from a Lived Experience Group (LEG) and a practitioner group.

The programme theories articulated through the realist review process will be further refined and enhanced through engagement with experts-by-experience to identify the key issues regarding the success of non-pharmacological interventions. The realist review will be followed with realist interviews which will be conducted to gather additional data to support, refute or refine the programme theory developed from the review.

The lived experience group (LEG) will inform and confirm findings from the realist evaluation and will enable a better understanding of non-pharmacological interventions in weight loss for people with SMI. The practitioner group will provide detail and clarity on the challenges practitioners incur in managing weight gain in people with SMI.

Findings

The involvement of the stakeholder group will allow the findings from the realist evaluation to be shaped according to their expertise and experiences. An overview of this process involving the LEG and practitioner groups will be produced. The key findings of the evaluation alongside the outcomes identified by the stakeholder group will be presented. The initial programme theory which will develop because of this collaborative process will incorporate the different contexts that trigger key mechanisms to produce these outcomes and improve quality of life for people living with severe mental illness.

Consequences

This realist evaluation will provide meaningful findings to inform the development of guidance on managing antipsychotic-induced weight gain and a framework for intervention design for people with severe mental illness. Furthermore, the findings of this evaluation will be used to inform a future grant application to develop a non-pharmacological intervention that will help manage weight in people living with severe mental illness.

Submitted by:

Gurkiran Birdi

Funding acknowledgement:

RESOLVE is funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.