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Table 1 Description of Nurse led intervention to promote screening for cardiovascular risk factors in people with SMI on the CMHT caseload.

From: Impact of a nurse-led intervention to improve screening for cardiovascular risk factors in people with severe mental illnesses. Phase-two cluster randomised feasibility trial of community mental health teams

Phase of screening

Components of intervention

Orientation

Write to all General Practitioner (GP) and community mental health teams (CMHTs) in the intervention arm to inform them of the nurse's work and the trial

Phase one: Liaison with primary care to prompt CVD screening

Months 1-3

-Create secure lists and database of all patients under the care of CMHT, including address of GP.

-Nurse writes to the GP of every patient explaining the rationale and evidence base for annual screening of cardiovascular risk in people with SMI

 

   i) Request that results of relevant CVD screening in the past year are sent to the nurse (including smoking and diabetic status, glucose, lipids, blood pressure and 10 year cardiovascular risk score). A proforma was provided.

 

   ii) Request that screening is arranged to assess any missing cardiovascular risk factors

 

-When no response was received, up to two reminders were sent to the GP at 2 weekly intervals.

Phase two: Liaison with secondary care to prompt CVD screening

Month 4

-Determine which patients have missing CVD risk factors on the nurse database.

-Contact CMHT key worker for each of these patients.

-Provide them with evidence and rationale for CVD screening in SMI

-Request that they organise screening for missing CVD risk factors (including the same risk factors as phase one)

-CMHT workers were provided with pathology request forms.

-Request that they communicate the results back to nurse

Phase three: Invitation to cardiovascular screening with nurse

Months 4-6

-Determine which patients have still not been screened by GP or CMHT key worker

-Write to patient explaining importance of annual CVD screening

-Invite patient to attend a scheduled CVD screening appointment with nurse at CMHT base.

(including the same risk factors as phase one)

-All results were sent to the patient and their GP