title: Feasibility and acceptability of patient partnership to improve access to primary care for the physical health of patients with severe mental illnesses: an interactive guide.
abstract: BACKGROUND
  Even in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses.
  
  
  METHODS
  A participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition.
  
  
  RESULTS
  Patient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners.
  
  
  CONCLUSIONS
  This research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.
authors.affiliation: Department of Psychiatry, University of Montreal, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401, Hochelaga Street, Montreal, QC, H1N 3M5, Canada. jean-francois.pelletier@yale.edu.|Department of Psychiatry, Yale School of Medicine, New Haven, USA. jean-francois.pelletier@yale.edu.|International Program for Participatory Action Research, Montréal, Canada. jean-francois.pelletier@yale.edu.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Pelletier
authors.affiliation: Department of Psychiatry, University of Montreal, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401, Hochelaga Street, Montreal, QC, H1N 3M5, Canada. alesage.iusmm@ssss.gouv.qc.ca.
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
authors.affiliation: International Program for Participatory Action Research, Montréal, Canada. boisvertchris@hotmail.com.
authors.forename: Christine
authors.initials: C
authors.lastname: Boisvert
authors.affiliation: La Chartreuse Psychiatric Centre, Dijon, France. frederic.denis@chs-chartreuse.fr.|University of Franche-Comte, Besançon, France. frederic.denis@chs-chartreuse.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Denis
authors.affiliation: Faculty of Nursing, University of Montreal, Montreal, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bonin
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Australia. s.kisely@uq.edu.au.
authors.forename: Steve
authors.initials: S
authors.lastname: Kisely
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010358:Patient Participation; D011792:Quebec; D011795:Surveys and Questionnaires