The UK STEPWISE Trial, a programme of STructured lifestyle Education for People With SchizophrEnia

Poster A116, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Stephen Wright1, Rebecca Gossage-Worrall2, David Shiers3, Paul French4, Richard Holt5; 1Leeds & York Partnership NHS Foundation Trust, 2University of Sheffield, 3University of Manchester, 4Greater Manchester West Mental Health NHS Foundation Trust, 5University of Southampton

People with schizophrenia and related psychotic disorders are significantly at risk of weight gain and associated cardiometabolic complications including diabetes. Antipsychotic medication plays a major role in this, and weight gain is most rapid in the early stages of treatment. Many current guidelines recommend structured healthy lifestyle interventions as part of the treatment plan, but there is a lack of good evidence to guide clinicians about what these should comprise. The challenge of poor engagement and reduced motivation prevents meaningful comparisons with other population groups. The STEPWISE study is a multi-centre randomised controlled trial of a structured lifestyle intervention for people taking antipsychotic medication for schizophrenia, schizoaffective disorder or first episode psychosis. The primary outcome is weight change (kg) at 12 months. Biomedical, economic and behavioural outcomes are also considered. The trial has successfully recruited to target from 10 NHS trusts across England. 414 participants were recruited in the 12 month recruitment phase, of whom 284 (68.6%) had a primary diagnosis of schizophrenia (ICD-10 F20), 66 (15.9%) schizoaffective disorder (F25) and 64 (15.5%) first episode psychosis. Participants were randomised to receive either the structured intervention or treatment as usual. The intervention was developed from a nationally approved diabetes structured education programme. It comprises 4 x weekly group lifestyle education sessions with trained facilitators, 3 monthly ‘booster’ sessions and fortnightly motivational support. The control group receive NICE concordant lifestyle information but no active programme. The follow up period is currently underway and the trial will conclude in March 2017.

Topic Area: First Episode Psychosis

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