Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol

N M den Bleijker; M M E van Schothorst; I J M Hendriksen; Wiepke Cahn; N K de Vries; P N van Harten; J Deenik

doi:10.1186/s12888-022-03801-w

Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol

N M den Bleijker, M M E van Schothorst^*, I J M Hendriksen, Wiepke Cahn, N K de Vries, P N van Harten, J Deenik

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: People with mental illness have a reduced life expectancy compared to the general population. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is often referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings. Our study assesses the effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +).

METHODS: An open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal, the Netherlands. The wards are divided into three clusters based on geographical region. These clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI + . MULTI + can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate the difference in the mean QRISK3 score of patients receiving MULTI + compared to patients receiving TAU. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors. Findings will be analysed using mixed model analyses.

DISCUSSION: The MULTI + study is the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors in routine inpatient mental health care. A limitation of this study is the risk of missing data due to the large-scale, real-world setting of this study. Furthermore, implementation monitoring and external events that may influence outcomes could be difficult to account for. Strengths of this study are the focus on effectiveness as well as implementation and the inclusion of both patient and health care professionals' perspectives. Effectiveness studies in routine clinical care can advance our knowledge on lifestyle interventions in real-world settings.

TRIAL REGISTRATION: ClinicalTrials.gov registration. Identifier: NCT04922749 . Retrospectively registered 3th of June 2021.

Original language	English
Article number	230
Number of pages	11
Journal	BMC Psychiatry
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12888-022-03801-w
Publication status	Published - 31 Mar 2022

Keywords

Humans
Inpatients
Life Style
Mental Disorders/psychology
Netherlands
Randomized Controlled Trials as Topic
Referral and Consultation
MORTALITY
SLEEP
Effectiveness
METAANALYSIS
Implementation
NATION OUTCOME SCALES
EXERCISE
PHYSICAL-ACTIVITY INTERVENTIONS
Lifestyle
PEOPLE
QUALITY-OF-LIFE
HEALTH
QUESTIONNAIRE
Mental illness

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Cite this

den Bleijker, N. M., van Schothorst, M. M. E., Hendriksen, I. J. M., Cahn, W., de Vries, N. K., van Harten, P. N., & Deenik, J. (2022). Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol. BMC Psychiatry, 22(1), Article 230. https://doi.org/10.1186/s12888-022-03801-w

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title = "Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol",

abstract = "BACKGROUND: People with mental illness have a reduced life expectancy compared to the general population. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is often referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings. Our study assesses the effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +).METHODS: An open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal, the Netherlands. The wards are divided into three clusters based on geographical region. These clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI + . MULTI + can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate the difference in the mean QRISK3 score of patients receiving MULTI + compared to patients receiving TAU. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors. Findings will be analysed using mixed model analyses.DISCUSSION: The MULTI + study is the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors in routine inpatient mental health care. A limitation of this study is the risk of missing data due to the large-scale, real-world setting of this study. Furthermore, implementation monitoring and external events that may influence outcomes could be difficult to account for. Strengths of this study are the focus on effectiveness as well as implementation and the inclusion of both patient and health care professionals' perspectives. Effectiveness studies in routine clinical care can advance our knowledge on lifestyle interventions in real-world settings.TRIAL REGISTRATION: ClinicalTrials.gov registration. Identifier: NCT04922749 . Retrospectively registered 3th of June 2021.",

keywords = "Humans, Inpatients, Life Style, Mental Disorders/psychology, Netherlands, Randomized Controlled Trials as Topic, Referral and Consultation, MORTALITY, SLEEP, Effectiveness, METAANALYSIS, Implementation, NATION OUTCOME SCALES, EXERCISE, PHYSICAL-ACTIVITY INTERVENTIONS, Lifestyle, PEOPLE, QUALITY-OF-LIFE, HEALTH, QUESTIONNAIRE, Mental illness",

author = "{den Bleijker}, {N M} and {van Schothorst}, {M M E} and Hendriksen, {I J M} and Wiepke Cahn and {de Vries}, {N K} and {van Harten}, {P N} and J Deenik",

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year = "2022",

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day = "31",

doi = "10.1186/s12888-022-03801-w",

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den Bleijker, NM, van Schothorst, MME, Hendriksen, IJM, Cahn, W, de Vries, NK , van Harten, PN & Deenik, J 2022, 'Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol', BMC Psychiatry, vol. 22, no. 1, 230. https://doi.org/10.1186/s12888-022-03801-w

Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +): a stepped wedge study protocol. / den Bleijker, N M; van Schothorst, M M E; Hendriksen, I J M et al.
In: BMC Psychiatry, Vol. 22, No. 1, 230, 31.03.2022.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +)

T2 - a stepped wedge study protocol

AU - den Bleijker, N M

AU - van Schothorst, M M E

AU - Hendriksen, I J M

AU - Cahn, Wiepke

AU - de Vries, N K

AU - van Harten, P N

AU - Deenik, J

PY - 2022/3/31

Y1 - 2022/3/31

N2 - BACKGROUND: People with mental illness have a reduced life expectancy compared to the general population. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is often referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings. Our study assesses the effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +).METHODS: An open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal, the Netherlands. The wards are divided into three clusters based on geographical region. These clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI + . MULTI + can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate the difference in the mean QRISK3 score of patients receiving MULTI + compared to patients receiving TAU. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors. Findings will be analysed using mixed model analyses.DISCUSSION: The MULTI + study is the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors in routine inpatient mental health care. A limitation of this study is the risk of missing data due to the large-scale, real-world setting of this study. Furthermore, implementation monitoring and external events that may influence outcomes could be difficult to account for. Strengths of this study are the focus on effectiveness as well as implementation and the inclusion of both patient and health care professionals' perspectives. Effectiveness studies in routine clinical care can advance our knowledge on lifestyle interventions in real-world settings.TRIAL REGISTRATION: ClinicalTrials.gov registration. Identifier: NCT04922749 . Retrospectively registered 3th of June 2021.

AB - BACKGROUND: People with mental illness have a reduced life expectancy compared to the general population. Despite the increasing evidence for the efficacy of lifestyle interventions there is little change in routine clinical care. This discrepancy is often referred to as the implementation gap and has caused a need for effectiveness and implementation research in real-world settings. Our study assesses the effectiveness and implementation of a multidisciplinary lifestyle focused approach in the treatment of inpatients with mental illness (MULTI +).METHODS: An open cohort stepped wedge cluster randomized trial in inpatients psychiatric wards of GGz Centraal, the Netherlands. The wards are divided into three clusters based on geographical region. These clusters are randomly allocated to one of the three pre-defined steps to integrate MULTI + . MULTI + can be tailored to fit individual psychiatric wards and includes 10 core components aimed at improving lifestyle factors. The primary outcome is to investigate the difference in the mean QRISK3 score of patients receiving MULTI + compared to patients receiving TAU. Secondary outcomes include somatic and mental health outcomes, lifestyle factors, and implementation factors. Findings will be analysed using mixed model analyses.DISCUSSION: The MULTI + study is the first large-scale study evaluating the long-term effects of a multidisciplinary, multicomponent approach aimed at improving lifestyle factors in routine inpatient mental health care. A limitation of this study is the risk of missing data due to the large-scale, real-world setting of this study. Furthermore, implementation monitoring and external events that may influence outcomes could be difficult to account for. Strengths of this study are the focus on effectiveness as well as implementation and the inclusion of both patient and health care professionals' perspectives. Effectiveness studies in routine clinical care can advance our knowledge on lifestyle interventions in real-world settings.TRIAL REGISTRATION: ClinicalTrials.gov registration. Identifier: NCT04922749 . Retrospectively registered 3th of June 2021.

KW - Humans

KW - Inpatients

KW - Life Style

KW - Mental Disorders/psychology

KW - Netherlands

KW - Randomized Controlled Trials as Topic

KW - Referral and Consultation

KW - MORTALITY

KW - SLEEP

KW - Effectiveness

KW - METAANALYSIS

KW - Implementation

KW - NATION OUTCOME SCALES

KW - EXERCISE

KW - PHYSICAL-ACTIVITY INTERVENTIONS

KW - Lifestyle

KW - PEOPLE

KW - QUALITY-OF-LIFE

KW - HEALTH

KW - QUESTIONNAIRE

KW - Mental illness

U2 - 10.1186/s12888-022-03801-w

DO - 10.1186/s12888-022-03801-w

M3 - Article

C2 - 35361168

SN - 1471-244X

VL - 22

JO - BMC Psychiatry

JF - BMC Psychiatry

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ER -