Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness
Abstract Background Cardiometabolic diseases are the main causes of death in persons with severe mental illness (SMI), highlighting the need to improve management of cardiovascular risk factors in both primary and specialized health care. The “Healthy Heart Tool” aims at helping health care workers...
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BMC
2025-02-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-06578-w |
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| author | Elisabeth Haug Lund-Stenvold Petter A. Ringen Ole A. Andreassen Torfinn L. Gaarden Cecilie B. Hartberg Erik Johnsen Silje Myklatun Kåre Osnes Kjetil Sørensen Arne Vaaler Serena Tonstad John A. Engh Anne Høye |
| author_facet | Elisabeth Haug Lund-Stenvold Petter A. Ringen Ole A. Andreassen Torfinn L. Gaarden Cecilie B. Hartberg Erik Johnsen Silje Myklatun Kåre Osnes Kjetil Sørensen Arne Vaaler Serena Tonstad John A. Engh Anne Høye |
| author_sort | Elisabeth Haug Lund-Stenvold |
| collection | DOAJ |
| description | Abstract Background Cardiometabolic diseases are the main causes of death in persons with severe mental illness (SMI), highlighting the need to improve management of cardiovascular risk factors in both primary and specialized health care. The “Healthy Heart Tool” aims at helping health care workers to identify persons at risk, and to initiate proper interventions. Here we investigate if the recommendations in the Healthy Heart Tool are followed one year after implementation and whether implementation of the tool improved cardiometabolic risk factors in SMI. Methods Data from 270 individuals with SMI from six Norwegian hospitals were collected at baseline and at 12 months after implementation of the Healthy Heart Tool throughout the health care services. Changes from baseline to 12 months follow-up were analyzed using chi-square and independent t-tests, whereas implementation effects were analyzed using logistic general linear mixed models. Results After implementing the Healthy Heart Tool, significantly more persons received dietary advice and/or salt restriction advice (75.5% vs. 84.8%, p = 0.035). After controlling for Body Mass Index (BMI) ≥ 30 and sex, there was an odds ratio (OR) of 8.9 (95% CI 1.42–55.77) for receiving dietary advice and/or advice on salt reduction. There was a significant reduction (p = 0.016) in numbers of participants with high levels of total serum cholesterol ≥ 5 mmol/ (54.4% vs. 46.3%). Conclusions Implementing the Healthy Heart Tool can increase awareness of cardiovascular risk factors in patients with SMI. The intervention increased the proportion of individuals who received dietary and salt reduction advice and decreased the proportion of individuals with high cholesterol levels. However, due to the small numbers, these results should be interpreted with caution. Nonetheless, the findings suggest that the Healthy Heart Tool may be an effective means for improving the management of cardiovascular risk factors in individuals with SMI in typical clinical settings. Trial registrations The trial was retrospectively registered in ClinicalTrials.gov 29.01.25, ID NCT 06807242. |
| format | Article |
| id | doaj-art-781908b1e8b84c14802301c166314de9 |
| institution | DOAJ |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Psychiatry |
| spelling | doaj-art-781908b1e8b84c14802301c166314de92025-08-20T03:03:50ZengBMCBMC Psychiatry1471-244X2025-02-0125111110.1186/s12888-025-06578-wImplementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illnessElisabeth Haug Lund-Stenvold0Petter A. Ringen1Ole A. Andreassen2Torfinn L. Gaarden3Cecilie B. Hartberg4Erik Johnsen5Silje Myklatun6Kåre Osnes7Kjetil Sørensen8Arne Vaaler9Serena Tonstad10John A. Engh11Anne Høye12Department of Clinical Medicine, UiT The Arctic University of NorwayDivision of Mental Health and Addiction, Oslo University HospitalInstitute of Clinical Medicine, University of OsloDivision of Mental Health and Substance Abuse, Diakonhjemmet HospitalDivision of Mental Health and Addiction, Oslo University HospitalDivision of Mental Health and Addiction, NORMENT Centre of Excellence, Oslo University HospitalDivision of Mental Health and Substance Abuse, Diakonhjemmet HospitalDivision of Mental Health and Substance Abuse, Diakonhjemmet HospitalDivision of Mental Health, St Olav’s University HospitalDepartment of Acute Psychiatry, St. Olav’s University HospitalSection for Preventive Cardiology Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University HospitalDivision of Mental Health and Addiction, Vestfold Hospital TrustDepartment of Clinical Medicine, UiT The Arctic University of NorwayAbstract Background Cardiometabolic diseases are the main causes of death in persons with severe mental illness (SMI), highlighting the need to improve management of cardiovascular risk factors in both primary and specialized health care. The “Healthy Heart Tool” aims at helping health care workers to identify persons at risk, and to initiate proper interventions. Here we investigate if the recommendations in the Healthy Heart Tool are followed one year after implementation and whether implementation of the tool improved cardiometabolic risk factors in SMI. Methods Data from 270 individuals with SMI from six Norwegian hospitals were collected at baseline and at 12 months after implementation of the Healthy Heart Tool throughout the health care services. Changes from baseline to 12 months follow-up were analyzed using chi-square and independent t-tests, whereas implementation effects were analyzed using logistic general linear mixed models. Results After implementing the Healthy Heart Tool, significantly more persons received dietary advice and/or salt restriction advice (75.5% vs. 84.8%, p = 0.035). After controlling for Body Mass Index (BMI) ≥ 30 and sex, there was an odds ratio (OR) of 8.9 (95% CI 1.42–55.77) for receiving dietary advice and/or advice on salt reduction. There was a significant reduction (p = 0.016) in numbers of participants with high levels of total serum cholesterol ≥ 5 mmol/ (54.4% vs. 46.3%). Conclusions Implementing the Healthy Heart Tool can increase awareness of cardiovascular risk factors in patients with SMI. The intervention increased the proportion of individuals who received dietary and salt reduction advice and decreased the proportion of individuals with high cholesterol levels. However, due to the small numbers, these results should be interpreted with caution. Nonetheless, the findings suggest that the Healthy Heart Tool may be an effective means for improving the management of cardiovascular risk factors in individuals with SMI in typical clinical settings. Trial registrations The trial was retrospectively registered in ClinicalTrials.gov 29.01.25, ID NCT 06807242.https://doi.org/10.1186/s12888-025-06578-wSevere mental illnessCardiovascular riskMortality risk reduction |
| spellingShingle | Elisabeth Haug Lund-Stenvold Petter A. Ringen Ole A. Andreassen Torfinn L. Gaarden Cecilie B. Hartberg Erik Johnsen Silje Myklatun Kåre Osnes Kjetil Sørensen Arne Vaaler Serena Tonstad John A. Engh Anne Høye Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness BMC Psychiatry Severe mental illness Cardiovascular risk Mortality risk reduction |
| title | Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| title_full | Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| title_fullStr | Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| title_full_unstemmed | Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| title_short | Implementation of the healthy heart tool- an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| title_sort | implementation of the healthy heart tool an algorithm with potential cardiometabolic health benefits in persons with severe mental illness |
| topic | Severe mental illness Cardiovascular risk Mortality risk reduction |
| url | https://doi.org/10.1186/s12888-025-06578-w |
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