Management of Antipsychotic Medication Associated Obesity - 2

抗精神病药物相关肥胖的管理 - 2

基本信息

批准号：
8839272
负责人：
DONNA Ames AMES
金额：
--
依托单位：
VA GREATER LOS ANGELES HEALTHCARE SYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8839272
关键词：
Address Adherence Adopted Adverse effects Advocate Ambulatory Care Facilities American Psychiatric Association Antipsychotic Agents Appointment Asorbicap Behavior Therapy Behavioral Body Weight decreased Cardiovascular system Caregivers Caring Cholesterol Community Integration Control Groups Coronary Arteriosclerosis Cost Savings Counseling Country Data Analyses Development Diabetes Mellitus Diagnostic Diagnostic and Statistical Manual of Mental Disorders Diet Disabled Persons Disease Education Effectiveness Emotional Equilibrium Exercise Family Family Relationship Financial cost Food Freedom Friendships Funding Grant Health Health Personnel Healthcare Healthcare Systems Heart Diseases Impaired cognition Independent Living Individual Intervention Interview Knowledge Lead Life Style Lipids Los Angeles Measures Medical Medical center Mental Health Mental disorders Mentally Ill Persons Metabolic Metabolic syndrome Methods Mission Modeling Monitor Morbidity - disease rate Motivation National Institute of Mental Health Neurobehavioral Manifestations Obesity Outcome Overweight Participant Patient Monitoring Patients Persons Pharmaceutical Preparations Population Protocols documentation Psyche structure Psychiatric therapeutic procedure Psychopathology Public Health Quality of life Questionnaires Randomized Recommendation Recovery Recreation Regimen Reporting Research Research Proposals Resources Risk Risk Factors Safety Schedule Schizophrenia Self Management Services Site Societies Substance abuse problem Surgeon Surveys Symptoms System Techniques Testing Translating Veterans Weight Weight Gain Weight maintenance regimen Wellness Program Work abstracting active method atypical antipsychotic base biopsychosocial cardiovascular risk factor cohort combat cost design diabetes prevention program diaries diet and exercise disability empowerment glucose tolerance health administration heart disease risk hospital utilization improved insight instrument intervention program lifestyle intervention meetings multi-component intervention nutrition patient home care prevent programs prospective psychoeducation psychosocial psychosocial rehabilitation severe mental illness skills training success treatment adherence treatment as usual treatment duration treatment program user-friendly web site weight loss intervention

Address Adherence Adopted Adverse effects Advocate Ambulatory Care Facilities American Psychiatric Association Antipsychotic Agents Appointment Asorbicap Behavior Therapy Behavioral Body Weight decreased Cardiovascular system Caregivers Caring Cholesterol Community Integration Control Groups Coronary Arteriosclerosis Cost Savings Counseling Country Data Analyses Development Diabetes Mellitus Diagnostic Diagnostic and Statistical Manual of Mental Disorders Diet Disabled Persons Disease Education Effectiveness Emotional Equilibrium Exercise Family Family Relationship Financial cost Food Freedom Friendships Funding Grant Health Health Personnel Healthcare Healthcare Systems Heart Diseases Impaired cognition Independent Living Individual Intervention Interview Knowledge Lead Life Style Lipids Los Angeles Measures Medical Medical center Mental Health Mental disorders Mentally Ill Persons Metabolic Metabolic syndrome Methods Mission Modeling Monitor Morbidity - disease rate Motivation National Institute of Mental Health Neurobehavioral Manifestations Obesity Outcome Overweight Participant Patient Monitoring Patients Persons Pharmaceutical Preparations Population Protocols documentation Psyche structure Psychiatric therapeutic procedure Psychopathology Public Health Quality of life Questionnaires Randomized Recommendation Recovery Recreation Regimen Reporting Research Research Proposals Resources Risk Risk Factors Safety Schedule Schizophrenia Self Management Services Site Societies Substance abuse problem Surgeon Surveys Symptoms System Techniques Testing Translating Veterans Weight Weight Gain Weight maintenance regimen Wellness Program Work abstracting active method atypical antipsychotic base biopsychosocial cardiovascular risk factor cohort combat cost design diabetes prevention program diaries diet and exercise disability empowerment glucose tolerance health administration heart disease risk hospital utilization improved insight instrument intervention program lifestyle intervention meetings multi-component intervention nutrition patient home care prevent programs prospective psychoeducation psychosocial psychosocial rehabilitation severe mental illness skills training success treatment adherence treatment as usual treatment duration treatment program user-friendly web site weight loss intervention

展开

项目摘要

DESCRIPTION (provided by applicant): Project Summary/Abstract: Introduction: Obesity and its related conditions such as diabetes and heart disease are unfortunate side effects of the medications used to treat veterans with severe mental illness. In combination, obesity and severe mental illness pose a huge public health problem. The FDA and the VA inspector general are concerned about the monitoring and safety of severely mentally ill patients taking antipsychotic medications. This research is designed to test a multi-modal approach to the problem of antipsychotic medication associated obesity over a 12-month period at 4 different VA settings. Though the MOVE program has been developed to combat obesity in the general VA population, there exists a large portion of patients with severe mental illness who cannot or will not access MOVE. This program is designed to fill the gap that usual care does not provide. This study will test this special intervention for severely mentally ill patients taking antipsychotic medications and comparing this intervention to usual care at 4 VA sites. Methods: 120 veterans from four different VA sites will be randomly assigned to either a 12 month multi-modal behavioral treatment program vs. usual care for the monitoring and treatment of medication associated obesity. The multi modal treatment approach, the Lifestyle Balance Program adopted from the federally funded Diabetes Prevention Program, is aimed at changing lifestyles and includes individual health coaching, and group classes weekly for the first 8 weeks, as well as a prescribed individualized plan for exercise and dietary changes that will result in weight loss. Additionally, counseling with caregivers on support of lifestyle changes will be provided and meal substitution will be implemented for veterans who have no control over food provided to them in institutional type settings (e.g. board and care homes). Following the initial 8 weeks, individual coaching and group booster classes will occur for the next 10 months on a monthly basis. This study will also test the ability of other VA sites to adopt a weight loss program for this particular population. Preliminary Results: This is a continuation of an ongoing program in which 120 veterans have already participated. Thus far, our preliminary results have been promising. We have observed twice the weight loss that we anticipated in the initial grant period over a year long weight loss program. We have seen improvements in certain symptoms of mental illness, as veterans appear to be more outgoing and less withdrawn. We also have seen a positive impact on veterans' well being and the quality of their lives. Additionally we have achieved with weight loss an improvement in risk factors for heart disease. This prolongs the lives of veterans with severe mental illness and translates into cost savings for veterans, their families, and society in general. This new study will determine if the success at our one site can be achieved at three additional sites.

描述（由申请人提供）：项目摘要/摘要：简介：肥胖及其相关状况（例如糖尿病和心脏病）是用于治疗患有严重精神疾病的退伍军人的药物的不幸副作用。结合起来，肥胖和严重的精神疾病构成了一个巨大的公共卫生问题。 FDA和VA监察长担心服用抗精神病药的严重患者的监测和安全性。这项研究旨在测试一种多模式方法，以解决在4个不同的VA环境中的12个月内抗精神病药物相关肥胖的问题。尽管已制定了该行动计划来打击普通VA人口中的肥胖症，但仍有大部分精神疾病患者无法获得或将无法移动。该程序旨在填补通常的护理所没有提供的空白。这项研究将测试这种特殊的干预措施，以针对服用抗精神病药物的严重患者，并将这种干预措施与4 VA部位的常规护理进行比较。方法：来自四个不同VA站点的120名退伍军人将被随机分配给12个月的多模式行为治疗计划，而对药物相关的肥胖症的监测和治疗通常。多模态治疗方法，即联邦资助的糖尿病预防计划采用的生活方式平衡计划，旨在改变生活方式，包括个人健康教练，每周在头8周内每周进行小组班，以及一项规定的个性化运动计划和饮食变化，这将导致体重减轻。此外，将向护理人员提供有关改变生活方式改变的咨询，并将针对无法控制在机构类型环境中提供给他们的食物的退伍军人（例如董事会和养老院）。在最初的8周之后，将在接下来的10个月内每月进行个人教练和小组助推课。这项研究还将测试其他VA站点对该特定人群采用减肥计划的能力。初步结果：这是一个正在进行的计划的延续，其中120名退伍军人已经参加了该计划。到目前为止，我们的初步结果一直很有希望。我们已经观察到了我们在一年长的减肥计划中预期的重量损失的两倍。我们已经看到了精神疾病的某些症状的改善，因为退伍军人似乎更外向，而撤离更少。我们还看到了对退伍军人的健康和生活质量的积极影响。此外，我们已经通过减肥来改善心脏病的危险因素。这延长了严重精神疾病的退伍军人的生命，并为退伍军人，他们的家庭和整个社会节省了成本。这项新的研究将确定在我们一个站点的成功是否可以在其他三个站点上取得成功。