Realist evaluation of non-pharmacological management of antipsychotic weight gain in SMI-LD dual diagnosis

Project Overview

Antipsychotics used to treat severe mental illnesses (SMI) such as schizophrenia often cause significant weight gain linked to diabetes and cardiovascular disease, reducing patients' life expectancy by up to 20 years. Existing research (NIHR RESOLVE study) used a realist approach to manage this weight gain non-pharmacologically but identified a lack of evidence for people with dual diagnosis of SMI and learning disability (LD).

This project aims to understand what works, for whom, and under what circumstances to manage antipsychotic weight gain non-pharmacologically in people with SMI-LD using a realist review and realist evaluation involving interviews with key stakeholders.

What You Will Do

The research plan includes three work packages (WP):

• WP1 (months 1-12): Conduct a realist review of academic and grey literature developing program theories to understand management strategies.
• WP2 (months 8-28): Carry out realist evaluation through semi-structured interviews with people with dual diagnosis, clinicians, and carers to validate and refine program theories and develop practical guidance.
• WP3 (months 26-36): Synthesize findings, produce thesis, and disseminate results to academics and policymakers.

Expected Outcomes

The project expects to produce guidance for clinicians and policymakers on effective non-pharmacological interventions to manage antipsychotic weight gain in people with SMI-LD. This will address a significant gap in research and improve health outcomes for this vulnerable population.

Why This Matters

Weight gain induced by antipsychotics significantly increases health risks and mortality in people with SMI. Addressing this through tailored non-pharmacological interventions for those with dual diagnosis of SMI and LD can reduce health inequalities and improve life expectancy and quality of life.