Enhanced health screening for people with severe mental illness in Hong Kong - results from a one year prospective case series study

Background
People with severe mental illness have significantly poorer physical health than the general population; previous health screening studies conducted outside Asian countries have demonstrated potential in addressing this issue. This case series aimed to explore the effects and utility of integrating an enhanced physical health screening programme for community dwelling patients with severe mental illness into routine clinical practice in Hong Kong.

Method
This study utilises a consecutive prospective case series design. The serious mental illness health improvement profile (HIP) was used as a screening tool at baseline and repeated at 12 months follow-up.

Results
A total of 148 community-based patients with severe mental illness completed the study. At one year follow-up analysis showed a significant improvement in self-reported levels of exercise and a reduction in the numbers of patients prescribed medications for diabetes However, mean waist circumference increased at follow-up. In addition to the statistically significant results some general trends were observed, including: a lack of deterioration in most areas of cardiovascular risk; a reduction in medicines prescribed for physical health problems; and general improvements in health behaviours over the 12 month period.

Conclusions
The findings demonstrate that using the HIP is feasible and acceptable in Hong Kong. The results of the enhanced physical health-screening programme are promising, but require further testing using a randomised controlled trial design in order to more confidently attribute the improvements in well-being and health behaviours to the HIP.