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...

Full description

Saved in:
Bibliographic Details
Main Authors: 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
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-025-06578-w
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849768346509115392
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
record_format Article
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
work_keys_str_mv AT elisabethhauglundstenvold implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT petteraringen implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT oleaandreassen implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT torfinnlgaarden implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT ceciliebhartberg implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT erikjohnsen implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT siljemyklatun implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT kareosnes implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT kjetilsørensen implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT arnevaaler implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT serenatonstad implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT johnaengh implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness
AT annehøye implementationofthehealthyhearttoolanalgorithmwithpotentialcardiometabolichealthbenefitsinpersonswithseverementalillness