title: Lowering Cardiovascular Disease Risk for People with Severe Mental Illnesses in Primary Care: A Focus Group Study.
abstract: BACKGROUND
  People with severe mental illnesses die early from cardiovascular disease. Evidence is lacking regarding effective primary care based interventions to tackle this problem.
  
  
  OBJECTIVE
  To identify current procedures for, barriers to, and facilitators of the delivery of primary care based interventions for lowering cardiovascular risk for people with severe mental illnesses.
  
  
  METHODS
  75 GPs, practice nurses, service users, community mental health staff and carers in UK GP practice or community mental health settings were interviewed in 14 focus groups which were audio-recorded, transcribed and analysed using Framework Analysis.
  
  
  RESULTS
  Five barriers to delivering primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses were identified by the groups: negative perceptions of people with severe mental illnesses amongst some health professionals, difficulties accessing GP and community-based services, difficulties in managing a healthy lifestyle, not attending appointments, and a lack of awareness of increased cardiovascular risk in people with severe mental illnesses by some health professionals. Identified facilitators included involving supportive others, improving patient engagement with services, continuity of care, providing positive feedback in consultations and goal setting.
  
  
  CONCLUSIONS
  We identified a range of factors which can be incorporated in to the design, delivery and evaluation of services to reduce cardiovascular risk for people with severe mental illnesses in primary care. The next step is determining the clinical and cost effectiveness of primary care based interventions for lowering cardiovascular risk in people with severe mental illnesses, and evaluating the most important components of such interventions.
authors: Epidemiology and Applied Clinical Research Department, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.
authors: Alexandra
authors: A
authors: Burton
authors: Epidemiology and Applied Clinical Research Department, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.
authors: David
authors: D
authors: Osborn
authors: Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom.
authors: Lou
authors: L
authors: Atkins
authors: Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom.
authors: Susan
authors: S
authors: Michie
authors: The McPin Foundation, London, United Kingdom.
authors: Ben
authors: B
authors: Gray
authors: Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, United Kingdom.
authors: Fiona
authors: F
authors: Stevenson
authors: Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, United Kingdom.
authors: Hazel
authors: H
authors: Gilbert
authors: Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, London, United Kingdom.
authors: Kate
authors: K
authors: Walters
mesh_terms: D001291:Attitude of Health Personnel; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D001523:Mental Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D059017:Primary Care Nursing / Q000523:psychology / Q000706:statistics & numerical data*