The Assertive Cardiac Care Trial (ACCT)

Project Details

People who live with severe mental illnesses have a higher likelihood of developing cardiovascular (or heart related) diseases than people who do not live with severe mental illness. The physical health needs of people who live with a severe mental illness need to be addressed more proactively.

An increased focus on the physical health of people who live with severe mental illnesses is essential in primary care to improve cardiovascular health outcomes. Health professionals can support screening, detection and management of heart disease and the factors that contribute to the development of heart related disease for people living with mental illnesses.

The Assertive Cardiac Care Trial (ACCT) is a national primary care-based initiative to test a new, remotely delivered intervention that has been co-produced with people who live with severe mental illness, to improve the heart health of people who live with severe mental illness.

I think anything that promotes a feeling to a patient of being proactively managed is very positive. It would help enlist that person's cooperation or investment in their own health and management. (Co-design participant)


ACCT is now actively recruiting GP clinics and participants nationally to be part of this exciting initiative: GENERAL PRACTICES - WE INVITE YOU TO JOIN THIS NATIONAL INITIATIVE

For more information or to sign up please get in touch:

healthy-hearts@unimelb.edu.au

1800 431 212

Key information
NHMRC Grant Number: GNT1141344
Ethics ID number: 185305
ANZCTR Trial Listing: ACTRN12619001112156

PROJECT DETAILS

ACCT is trialing a co-produced approach to improve the heart health of people who live with severe mental illness. This is delivered in partnership with general practitioners and staff across the primary care setting.  The intervention will be delivered remotely using a tailored virtual care platform and adjunct research nurse care.

If you are a general practitioner or practice manager across Australia, we invite you and your practice to join this important national initiative to determine whether this new approach can help improve heart health outcomes for people who live with severe mental illness.

OVERVIEW

People who live with severe mental illnesses are more likely to develop cardiovascular - or heart related - disease (CVD). This is seen across all age groups, and we know that part of the problem is unmet physical health needs.  The factors leading to unmet physical health needs are complex and involve interconnected structural, individual, and social factors.  These include poor continuity of care across sectors, stigma associated with seeking help, unwelcoming health care environments, and 'diagnostic over shadowing' where physical health symptoms are attributed to the diagnosed mental illness instead of being addressed.

Many of the factors that increase the rates of CVD in people with severe mental illness can be improved by combining pharmacological (where appropriate) and non-pharmacological (primarily diet, behavioural, lifestyle and physical activity) interventions.

A targeted, individualised and multifactorial intervention is urgently needed. Primary care is the place to deliver this to improve CVD outcomes in people with SMI as General Practitioners maintain ongoing relationships with patients allowing for a collaborative, holistic, ongoing approach to health management.  General Practitioners are also able to initiate and coordinate care across primary, secondary and tertiary sectors leading to greater continuity of care and treatment adherence.

We have developed a co-produced, person-centred and evidence-based approach with people living with severe mental illnesses, general practitioners and psychiatrists, nurses and researchers.  The study design has had substantial input from GPs involved in the project and builds on our experience working in primary care as a core team based in the Department of General Practice at the University of Melbourne. More information can be found below.

Information for GPs and Practice Managers

Download further information - GPs and Practice Managers

Additional Resources:

GP Study Brochure

Information for Participants

Download further information - Participants

Additional Resources:

Study Brochure

Study Flyer/postcard

Detailed Information on the ACCT Healthy Hearts Study (Plain Language Statement)

Researchers

A/Prof Victoria Palmer, Lead Investigator
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

Dr Matthew Lewis, Trial Manager and Research Fellow
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

Maria Potiriadis, Trial Engagement & Coordination
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

Emily Knights, Research Nurse
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

A/Prof Patty Chondros, Biostatistician
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences.  The University of Melbourne

Konstancja Densley, Data Manager
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

David Ormiston-Smith, Web Developer
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

Collaborators

Prof Jane Gunn
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences (University of Melbourne)

Prof Carol Harvey
The Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences. University of Melbourne

A/Prof John Furler
The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences.  University of Melbourne

Prof David Osborn
Division of Psychiatry, Faculty of Brain Sciences, University College London

Prof David Castle
The Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences. University of Melbourne.

Dr Sandra Davidson
(Honorary Research Fellow) The Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences.  University of Melbourne

Dr Mahesh Jayaram
The Department of Psychiatry, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences. University of Melbourne

Prof Amanda Kenny
La Trobe Rural Health School, Department of Rural Nursing and Midwifery.  La Trobe University.

Prof Cathy Mihalopoulos
Deakin Health Economics Unit, Faculty of Health, Deakin University.

Prof Mark Nelson
Menzies Institute for Medical Research; School of Medicine, University of Tasmania

Prof Vera Morgan
Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia

Prof Stephen Harrap
Department of Physiology, University of Melbourne

Funding

The Assertive Cardiac Care Trial (ACCT) is funded by an NHMRC Project Grant (2018)
APP1141344

Research Publications

Lewis M, Chondros P, Mihalopoulos C, Lee YY, Gunn JM, Harvey C, Furler J, Osborn D, Castle D, Davidson S, Jayaram M, Kenny A, Nelson MR, Morgan VA, Harrap S, McKenzie K, Potiriadis M, Densley K, & Palmer VJ (2020). The assertive cardiac care trial: A randomised controlled trial of a coproduced assertive cardiac care intervention to reduce absolute cardiovascular disease risk in people with severe mental illness in the primary care setting. Contemporary Clinical Trials, 97, 106143. https://doi.org/10.1016/j.cct.2020.106143

Palmer VJ, Lewis M, Stylianopolous V, Furler J. Primary care prevention of the cardiovascular health crisis for people with severe mental illnesses. Australian Journal of General Practice. 2018;47(12):846-50.https://www1.racgp.org.au/ajgp/2018/december/primary-care-prevention-of-the-cardiovascular-heal

Research Group

Integrated Mental Health




Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

General Practice

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