Abstract
Background:
People living with severe mental illness (SMI) can experience greater risk of premature mortality than the general population, with preventable physical ill health majorly contributing. Physical health checks are a strategy to improve physical health but uptake is variable.
Aim:
To collate and assess the published evidence on the effectiveness of interventions to increase access to and uptake of physical health reviews for people living with SMI. Design and setting: Systematic review.
Methods:
We searched three databases (MEDLINE, CINAHL and PsycInfo) for studies evaluating interventions aiming to increase access to and uptake of physical health checks for people with SMI. Searches were conducted October-November 2024 for studies published from 2000 onwards. We included studies reporting on outcomes of uptake or receipt of physical health checks or screening, including cancer screening. Both randomised controlled trials (RCTs) and comparative non-randomised studies were eligible. We assessed risk of bias using Cochrane RoB 2 and ROBINS-I tools. Data synthesis involved an effect direction plot. Results: Of 4437 identified studies, 12 were eligible. Intervention categories were case management (n=2), financial incentivisation (n=3), service change (n=5), invitation (n=1) and mixed (n=1). Two RCTs showed a positive effect of a case management approach; with one study having “high” concerns of bias. For other interventions, diverse non-randomised studies were included, with either positive or mixed findings and risk of bias ranging from “moderate” to “critical”.
Conclusion:
We identified a scarcity of data and while a case-management approach shows promise, there should be further robust and high-quality research.
People living with severe mental illness (SMI) can experience greater risk of premature mortality than the general population, with preventable physical ill health majorly contributing. Physical health checks are a strategy to improve physical health but uptake is variable.
Aim:
To collate and assess the published evidence on the effectiveness of interventions to increase access to and uptake of physical health reviews for people living with SMI. Design and setting: Systematic review.
Methods:
We searched three databases (MEDLINE, CINAHL and PsycInfo) for studies evaluating interventions aiming to increase access to and uptake of physical health checks for people with SMI. Searches were conducted October-November 2024 for studies published from 2000 onwards. We included studies reporting on outcomes of uptake or receipt of physical health checks or screening, including cancer screening. Both randomised controlled trials (RCTs) and comparative non-randomised studies were eligible. We assessed risk of bias using Cochrane RoB 2 and ROBINS-I tools. Data synthesis involved an effect direction plot. Results: Of 4437 identified studies, 12 were eligible. Intervention categories were case management (n=2), financial incentivisation (n=3), service change (n=5), invitation (n=1) and mixed (n=1). Two RCTs showed a positive effect of a case management approach; with one study having “high” concerns of bias. For other interventions, diverse non-randomised studies were included, with either positive or mixed findings and risk of bias ranging from “moderate” to “critical”.
Conclusion:
We identified a scarcity of data and while a case-management approach shows promise, there should be further robust and high-quality research.
| Original language | English |
|---|---|
| Article number | BJGP.2024.0826 |
| Pages (from-to) | e910-e917 |
| Journal | British Journal of General Practice |
| Volume | 76 |
| Issue number | 762 |
| Early online date | 2 Sept 2025 |
| DOIs | |
| Publication status | Published - 17 Nov 2025 |
Bibliographical note
Publisher Copyright:© 2025, The Authors.
