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Liraglutide and the management of overweight and obesity in people with severe mental illness: qualitative sub-study

Liraglutide and the management of overweight and obesity in people with severe mental illness: qualitative sub-study
Liraglutide and the management of overweight and obesity in people with severe mental illness: qualitative sub-study

Background: People with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality. Liraglutide 3 mg is a once daily injectable GLP-1 receptor agonist that is licensed for the treatment of obesity in the general population and has the potential to be used in people with severe mental illness. Aims: To record the expectations and experiences of people with schizophrenia, schizoaffective disorders or first episode psychosis taking daily liraglutide 3 mg injections in a clinical trial for the treatment of obesity. To seek the views of healthcare professionals about the feasibility of delivering the intervention in routine care. Methods: Qualitative interviews were undertaken with a purposive sub-sample of people with schizophrenia, schizoaffective disorders or first episode psychosis with overweight or obesity who were treated with a daily injection of liraglutide 3 mg in a double-blinded, randomised controlled pilot study evaluating the use of liraglutide for the treatment of obesity. Interviews were also conducted with healthcare professionals. Results: Seventeen patient participants were interviewed. Sixteen took part in the baseline interview, eight completed both baseline and follow-up interviews, and one took part in follow-up interview only. Mean interview duration was thirteen minutes (range 5-37 min). Despite reservations by some participants about the injections before the study, most of those who completed the trial reported no challenges in the timing of or administering the injections. Key themes included despondency regarding prior medication associated weight gain, quality of life impact of weight loss, practical aspects of participation including materials received and clinic attendance. Healthcare professionals reported challenges with recruitment, however, overall it was a positive experience for them and for participants. Conclusion: Liraglutide appears to be an acceptable therapy for obesity in this population with limited side effects. The quality of life benefits realised by several intervention participants reinforce the biomedical benefits of achieved weight loss.

Liraglutide, Obesity, Overweight, Psychosis, Schizophrenia, Severe mental illness
1471-244X
Barnard-Kelly, Katharine
f1910c7a-ae2a-4946-81f7-88f5c7fd736d
Whicher, Clare, Alexandra
1b9087ee-5445-4830-9b68-e9424d96e6a7
Price, Hermione
0a2df460-b71e-4b2b-b5de-e6f0267d66be
Phiri, Peter
6383dae9-2df4-4a22-aa61-81c174102cef
Rathod, Shanaya
b4dddbe5-e4aa-4069-bd03-20cd6332639c
Asher, Carolyn
080f274d-1d6a-41c0-99bc-8f1150b2788a
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393
Barnard-Kelly, Katharine
f1910c7a-ae2a-4946-81f7-88f5c7fd736d
Whicher, Clare, Alexandra
1b9087ee-5445-4830-9b68-e9424d96e6a7
Price, Hermione
0a2df460-b71e-4b2b-b5de-e6f0267d66be
Phiri, Peter
6383dae9-2df4-4a22-aa61-81c174102cef
Rathod, Shanaya
b4dddbe5-e4aa-4069-bd03-20cd6332639c
Asher, Carolyn
080f274d-1d6a-41c0-99bc-8f1150b2788a
Peveler, Robert
93198224-78d9-4c1f-9c07-fdecfa69cf96
Holt, Richard
d54202e1-fcf6-4a17-a320-9f32d7024393

Barnard-Kelly, Katharine, Whicher, Clare, Alexandra, Price, Hermione, Phiri, Peter, Rathod, Shanaya, Asher, Carolyn, Peveler, Robert and Holt, Richard (2022) Liraglutide and the management of overweight and obesity in people with severe mental illness: qualitative sub-study. BMC Psychiatry, 22 (21), [21]. (doi:10.1186/s12888-021-03666-5).

Record type: Article

Abstract

Background: People with severe mental illness are two to three times more likely to be overweight or have obesity than the general population and this is associated with significant morbidity and premature mortality. Liraglutide 3 mg is a once daily injectable GLP-1 receptor agonist that is licensed for the treatment of obesity in the general population and has the potential to be used in people with severe mental illness. Aims: To record the expectations and experiences of people with schizophrenia, schizoaffective disorders or first episode psychosis taking daily liraglutide 3 mg injections in a clinical trial for the treatment of obesity. To seek the views of healthcare professionals about the feasibility of delivering the intervention in routine care. Methods: Qualitative interviews were undertaken with a purposive sub-sample of people with schizophrenia, schizoaffective disorders or first episode psychosis with overweight or obesity who were treated with a daily injection of liraglutide 3 mg in a double-blinded, randomised controlled pilot study evaluating the use of liraglutide for the treatment of obesity. Interviews were also conducted with healthcare professionals. Results: Seventeen patient participants were interviewed. Sixteen took part in the baseline interview, eight completed both baseline and follow-up interviews, and one took part in follow-up interview only. Mean interview duration was thirteen minutes (range 5-37 min). Despite reservations by some participants about the injections before the study, most of those who completed the trial reported no challenges in the timing of or administering the injections. Key themes included despondency regarding prior medication associated weight gain, quality of life impact of weight loss, practical aspects of participation including materials received and clinic attendance. Healthcare professionals reported challenges with recruitment, however, overall it was a positive experience for them and for participants. Conclusion: Liraglutide appears to be an acceptable therapy for obesity in this population with limited side effects. The quality of life benefits realised by several intervention participants reinforce the biomedical benefits of achieved weight loss.

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Accepted/In Press date: 7 December 2021
Published date: 7 January 2022
Additional Information: Funding Information: The study team were awarded an Investigator led grant by Novo Nordisk Ltd. The work was also partly supported by the National Institute of Health Research (NIHR) Research Capability wing allocation to Southern Health NHS Foundation Trust (supporting the Clinical Research Fellow CAW). The protocol was designed by the investigators and the funders had no role in the data collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the paper for publication. Publisher Copyright: © 2022, The Author(s).
Keywords: Liraglutide, Obesity, Overweight, Psychosis, Schizophrenia, Severe mental illness

Identifiers

Local EPrints ID: 454446
URI: http://eprints.soton.ac.uk/id/eprint/454446
ISSN: 1471-244X
PURE UUID: 178d1c68-027b-4f4d-ac60-ac572eaccaaf
ORCID for Robert Peveler: ORCID iD orcid.org/0000-0001-5596-9394
ORCID for Richard Holt: ORCID iD orcid.org/0000-0001-8911-6744

Catalogue record

Date deposited: 09 Feb 2022 17:44
Last modified: 13 Jan 2023 02:37

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Contributors

Author: Katharine Barnard-Kelly
Author: Clare, Alexandra Whicher
Author: Hermione Price
Author: Peter Phiri
Author: Shanaya Rathod
Author: Carolyn Asher
Author: Robert Peveler ORCID iD
Author: Richard Holt ORCID iD

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