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The ACCT Healthy Hearts StudyAssertive Cardiac Care Trial in People with Severe Mental Illness in Primary Care

We are approaching GPs and primary care clinics to participate in The Assertive Cardiac Care Trial (ACCT) a randomised control trial of an assertive care intervention to reduce cardiovascular disease risk in people with severe mental illness in the primary care setting2

3Why are we focused on heart health in this group?Schizophrenia Bipolar disorderPsychosis Major depression

4Why are we focused on heart health in this group?

5Why are we focused on heart health in this group?

6The ACCT Healthy Hearts Study• Is a 5 year randomised control trial funded by the National Health and Medical Research Council(GNT1141344) running until Dec 2023• Has ethics approval at The University of Melbourne• Is a national initiative to improve cardiovascular health in the high needs population with severe mental illness

7The ACCT intervention• Has been co-designed by people with lived experience of severe mental illness, GPs, nurses and allied health staff.• Delivered remotely using a bespoke telehealth platform or via phone depending on participant preference.• Supports standard clinical care with focused goal setting, monitoring and support through the trial.

8The ACCT interventionA study employed research nurse will work remotely with participants to:• Review heart health results and identify lifestyle and modifiable risk factors that can be improved• Set SMART goals to improve their heart health• Work fortnightly with participants to achieve their goals over 12 months• Liaise with GP and clinic on progress and any clinically significant information identified

9The ACCT intervention

• Have an existing diagnosis of severe mental Illness, (schizophrenia, psychosis, bipolar disorder, major depression), and/ or are prescribed antipsychotic medication• Are aged 35-74 years old• Can provide informed consent via a two-stage consent process involving three brief true/false questions to ensure understanding of involvement. • Are English speaking or can understand written/spoken English.People will be ineligible if they have a: Severe acute physical illness, previous CVD event, acute mania or psychosis at enrolment (we will re-approach after a period of time), pregnancy or breast feeding10Participant eligibility criteria are:

• A dedicated research nurse to focus on the cardiovascular health of people with severe mental illness• Increased clinical information on the cardiovascular health of your patients and assistance with goal attainment, monitoring and medication compliance• A structured care plan that can be incorporated into a GP management plan• Access to activities providing 40 category 1 CPD points for participating GPs• A plaque for your primary care clinic and inclusion in QI activitiesParticipation in a National Initiative to improve physical health in people with Severe Mental Illness11The benefits to you and your practice include

• Receiving a targeted and personalised intervention to identify and address CVD risks– Our pilot testing with patients identified that they are very positive about having a dedicated nurse to work with over the course of a year on their heart health• GP management plan or Team Care arrangement (as appropriate) with ongoing follow-up and monitoring [that will meet MBS funding requirements]• Integration of the study intervention with clinical practice• Ongoing monitoring of medication adherence and identification of issues at an early stage after medication initiated or updated12The benefits for intervention patients include

1. Identifying eligible patients– We will provide a search strategy developed for your EMR to identify eligible patients.2. Provide Baseline Heart Health Information to the study– Using existing data or through a new ACVDR assessment, provide baseline information to study staff.3. See your patient as per usual over the next 12 months– For intervention patients, the research nurse will update the clinic with goals and clinically relevant information through the study4. Conduct 12 month Heart Health Checks for participants– Complete a ACVDR assessment on all participantsClinical responsibility for patients will always remain with the treating GP13To support the trial we ask your clinic to help

1. Field all study enquiries- This can be done via 1800 number; email; or through returning a study postcard back to research team at the University2. Conduct Consent and Baseline assessments via phone- All consent and baseline assessments will be conducted remotely- Participants will provide verbal consent which will be recorded- Participants will be booked for a baseline heart health check at the clinic3. Liaise with clinic staff regarding appointments and study activities4. Conduct assessments at baseline, 6 months and 12 months14University based study staff will

15Click the links below for further informationThe published study protocol (pre-COVID-19)Please note this has been updated to allow for national recruitment and remote study activitiesThe study registration at the Australia New Zealand Clinical Trials Registry The study webpage at the University of MelbourneA review of primary care prevention for cardiovascular health in people with severe mental illness

Thank you