Short summary

The aim of the SOFIA study is to improve quality of life, and bring about longer lives, for people with severe mental illness through general practice. In the SOFIA pilot study we test the feasibility and fidelity of a prolonged consultation with a special focus on the physical health

Rationale

How can general practice increase the quality of life and extend the life of people with severe mental illness?

People with severe mental illness live on average 10-20 years less than the general population. The causes are many, and include accidents, suicide and abuse but also the high incidence of physical illnesses (multimorbidity). The simultaneous experience of multiple diseases creates complex health problems that the current health system is not optimally designed to deal with. This tends to lead to a shorter life span due to poorer diagnosis and treatment of physical illnesses among this important patient group, as well as an overall experience of treatment as fragmented and uncoordinated.

For those patients who are very ill, are socially disadvantaged or have a poor social network, it is particularly difficult to obtain appropriate access to relevant health services. In addition, many have sparse contact with their own GP. Health inequality is often the result.

The SOFIA study has been co-designed with the involvement of all relevant actors in the field, including patients, relatives, patient associations, GPs, municipal staff, psychiatrists and others, in order to address the above problems. This initial co-design phase has shown that general practice is capable of solving many of the above problems should they be granted increased knowledge and competence in dealing with citizens with severe mental illness as well as more time for addressing complex problems and increasing the focus on somatic disease independent of mental illness. he SOFIA study intervention consists of 3 main components:

Ongoing training and support for GPs in the management of people with severe mental illness

Tracing of physical illnesses through active contact between GP and patients

An extended overview consultation up to 45 minutes with time for preparation in duration structured in accordance with the SOFIA model, as well as additional follow-up in general practice and other sectors when relevant.

Description of the cohort

12 General practices in the Capital Region and Region Zealand. Assigned at random to the intervention (8) or control groups (4). Each general practice recurit at least to patients with severe depression, bipolar disorder og schizophrenia, respectively.

Data and biological material

Demografic data, questionnaire data, patient journal,

Publications associated with the project

The SOFIA pilot trial : a cluster-randomized trial of coordinated, co-produced care to reduce mortality and improve quality of life in people with severe mental illness in the general practice setting. / Rozing, M. P.; Jønsson, A.; Koster-Rasmussen, R.; Due, T. D.; Brodersen, J.; Bissenbakker, K. H.; Siersma, Volkert; Mercer, S. W.; Guassora, A. D.; Kjellberg, J.; Kjellberg, P. K.; Nielsen, M. H.; Christensen, I. ; Bardram, J. E.; Martiny, F.; Møller, A.; Reventlow, S.; SOFIA Study Grp.