Adherence
Intensive lifestyle coaching combined with care coordination does not reduce 10-year cardiovascular disease risk or improve secondary health outcomes in people with schizophrenia spectrum disorders and abdominal obesity compared to treatment as usual.
For individuals with severe mental illness and obesity, intensive lifestyle coaching and care coordination do not appear to offer additional cardiovascular benefits over standard medical care alone. While the intervention was well-intentioned and assertive, it did not lead to significant improvements in weight, fitness, or cardiovascular risk factors over two years. Clinicians should manage expectations and focus on standard medical management of risk factors, as behavioral interventions alone may not be sufficient for this population.
We conclude that there was neither any direct nor any long-term effect of individual lifestyle coaching or care coordination on cardiovascular risk factors in people with abdominal obesity and schizophrenia spectrum disorders.
Why this rating
Large, randomized, multi-center clinical trial with 428 participants and 2-year follow-up, though with some limitations in outcome validation for this specific population.
Source
Effect of lifestyle coaching versus care coordination versus treatment as usual in people with severe mental illness and overweight: Two-years follow-up of the randomized CHANGE trial
Ane Storch Jakobsen et al. · PLoS ONE · 2017
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