The Fusion Clinic: integrating the care of people with severe mental illness and diabetes
The Fusion Clinic: integrating the care of people with severe mental illness and diabetes
Aim: People with coexisting severe mental illness (SMI) and type 2 diabetes have a shorter life expectancy and poorer diabetes outcomes than those without SMI. This is partly explained by the separate treatment of diabetes and SMI, which occurs in parallel silos in many healthcare systems. The Steno Diabetes Center Sjaelland and Region Zealand established the Fusion Clinic to offer combined psychiatric and diabetes care delivered by both diabetes and mental healthcare professionals. This study describes how the clinic was established and the initial diabetes outcomes. Methods: The Fusion Clinic was co-designed by people with diabetes and SMI and healthcare professionals to improve the care of adults with diabetes and SMI. The clinic approach utilised the F-ACT model. The 63 people referred to the Fusion Clinic between 01.02.2020 and 01.01.2022 who attended the clinic for more than 6 months were included in this study. Diabetes outcomes were recorded in the electronic medical records (Sundhedsplatformen EPIC). Results: There was a high prevalence of diabetes complications at baseline. Furthermore, 70% had one or more additional concomitant diseases, as well as SMI and diabetes. Assessment of diabetes complications and measurements of HbA
1c and lipid profile improved after referral to the clinic. HbA
1c declined during the first 6 months of attendance at the clinic. Conclusions: This model of service delivery has the potential to improve the quality of care for people with SMI and type 2 diabetes.
combined care clinics, diabetes, psychiatric disorders, severe mental illness, type 1 diabetes, type 2 diabetes
Rønne, Sabrina Trappaud
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Hansen, Anne B.
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Zabell, Vicki
3f1a3749-63ea-4048-aedc-414ea7f9e03e
Santos, Monica
9fd5eff2-68ae-455f-88ba-f96dd4d8b7a2
Olsen, Mette Wallbohm
d8510127-3623-456a-8c57-3a53cc3f9c2e
Iversen, Peter Bindslev
338a1116-b21c-4ecc-9cd0-be59d529b46b
Tarnow, Lise
2143d628-0937-4525-aef8-a955925720d7
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Rønne, Sabrina Trappaud
36cab744-64f1-4973-9ff6-cbb4c13b1baa
Hansen, Anne B.
5a096318-b22c-4ea4-82fd-73341c17492e
Zabell, Vicki
3f1a3749-63ea-4048-aedc-414ea7f9e03e
Santos, Monica
9fd5eff2-68ae-455f-88ba-f96dd4d8b7a2
Olsen, Mette Wallbohm
d8510127-3623-456a-8c57-3a53cc3f9c2e
Iversen, Peter Bindslev
338a1116-b21c-4ecc-9cd0-be59d529b46b
Tarnow, Lise
2143d628-0937-4525-aef8-a955925720d7
Holt, Richard I.G.
d54202e1-fcf6-4a17-a320-9f32d7024393
Rønne, Sabrina Trappaud, Hansen, Anne B., Zabell, Vicki, Santos, Monica, Olsen, Mette Wallbohm, Iversen, Peter Bindslev, Tarnow, Lise and Holt, Richard I.G.
(2023)
The Fusion Clinic: integrating the care of people with severe mental illness and diabetes.
Diabetic Medicine, [e15255].
(doi:10.1111/dme.15255).
Abstract
Aim: People with coexisting severe mental illness (SMI) and type 2 diabetes have a shorter life expectancy and poorer diabetes outcomes than those without SMI. This is partly explained by the separate treatment of diabetes and SMI, which occurs in parallel silos in many healthcare systems. The Steno Diabetes Center Sjaelland and Region Zealand established the Fusion Clinic to offer combined psychiatric and diabetes care delivered by both diabetes and mental healthcare professionals. This study describes how the clinic was established and the initial diabetes outcomes. Methods: The Fusion Clinic was co-designed by people with diabetes and SMI and healthcare professionals to improve the care of adults with diabetes and SMI. The clinic approach utilised the F-ACT model. The 63 people referred to the Fusion Clinic between 01.02.2020 and 01.01.2022 who attended the clinic for more than 6 months were included in this study. Diabetes outcomes were recorded in the electronic medical records (Sundhedsplatformen EPIC). Results: There was a high prevalence of diabetes complications at baseline. Furthermore, 70% had one or more additional concomitant diseases, as well as SMI and diabetes. Assessment of diabetes complications and measurements of HbA
1c and lipid profile improved after referral to the clinic. HbA
1c declined during the first 6 months of attendance at the clinic. Conclusions: This model of service delivery has the potential to improve the quality of care for people with SMI and type 2 diabetes.
Text
Revised Fusion Clinic paper_with_changes_accepted_SUBMITTED_20231026_Clean_file_ACCEPTED_20231030
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Accepted/In Press date: 30 October 2023
e-pub ahead of print date: 1 November 2023
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Publisher Copyright:
© 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
Keywords:
combined care clinics, diabetes, psychiatric disorders, severe mental illness, type 1 diabetes, type 2 diabetes
Identifiers
Local EPrints ID: 483798
URI: http://eprints.soton.ac.uk/id/eprint/483798
ISSN: 0742-3071
PURE UUID: 708ca587-cf4d-4ff5-842b-fac333dabc03
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Date deposited: 06 Nov 2023 17:57
Last modified: 27 Mar 2024 02:37
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Contributors
Author:
Sabrina Trappaud Rønne
Author:
Anne B. Hansen
Author:
Vicki Zabell
Author:
Monica Santos
Author:
Mette Wallbohm Olsen
Author:
Peter Bindslev Iversen
Author:
Lise Tarnow
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