Bridging public and private health services to best meet the cardiometabolic needs of people with severe mental illness: a retrospective cohort study.

Abstract

Cardiovascular disease is the leading cause of premature mortality in people with severe mental illness (SMI). Despite this, there lacks consensus regarding the most appropriate platform to monitor and treat cardiometabolic risk factors in this cohort. The current study aims to evaluate the effectiveness of tailored cardiometabolic healthcare in a private, GP-led clinic for people with SMI. A total of 63 adults with SMI were referred to a private GP-led cardiometabolic clinic from a neighbouring inner-city mental health service, where they received individualised cardiometabolic healthcare free-of-charge between 2014 and 2020. Paired t test was used to measure change in cardiometabolic data over the course of treatment. Chi-squared and Fisher's Exact tests were used to examine differences in demographic data and client engagement. Over a mean period of 9months, there was a significant mean reduction of weight (2.1kg), BMI (0.72kg/m2) and waist circumference (6cm). Engagement over a longer period was associated with stable accommodation and improved cardiometabolic outcomes. Targeted referral for individualised cardiometabolic interventions can lead to clinically significant improvement in cardiometabolic outcomes, providing a cause for therapeutic optimism when approaching physical health in people with SMI.