Managing mind and body

Evidence suggests that schizophrenia patients may have a genetic predisposition to developing certain metabolic abnormalities and this liability is exacerbated by the typically unhealthy lifestyle of most schizophrenia sufferers(1).

The life expectancy for individuals with schizophrenia is around 20% shorter than the life expectancy for the general population. Approximately two-thirds of this mortality is thought to result from physical health problems(1).

Similarly, obesity is a particular concern in the management of patients with bipolar disorder since antipsychotic drugs, mood stabilizers and many antidepressant medications are all associated with weight gain. Obesity is a risk factor for metabolic syndrome, type 2 diabetes, hypertension, heart disease and some cancers(2).

The need to prevent or reverse weight gain cannot be separated from the need to improve other aspects of lifestyle relevant to a reduction in cardiovascular disease e.g. increase exercise levels, decrease smoking and improve diet. Even relatively small weight losses offer health benefits. A weight loss of just 5% of body weight in obese individuals may result in clinically meaningful reductions in morbidity and mortality(1).

Optimum intervention should focus on controlling their mental condition as well as healthy eating and appropriate exercising. Stopping antipsychotic medication is not an option for these patients, since the risk of relapse is often devastating.

Eli Lilly, the pharmaceutical company which manufactures the antipsychotic Zyprexa, in collaboration with Virgin Life Care has been offering the Lilly Wellness Plus Programme to patients since March 2006 to motivate its customers to get moving, to eat more healthily and to live life with greater vigour.

The Lilly Wellness Plus programme is a 12-month programme involving personalised eating plans and exercise programmes designed specifically for each patient. The service includes unlimited access to professional biokineticists and dieticians. It also offers coaching and counselling via the telephone, e-mail and/or the web.

"It has become increasingly evident that drug therapy alone won’t serve the needs of patients suffering with psychotic illness. Other important non-drug interventions such as exercise, health and dietary advice are needed. Lilly has considered and researched these needs and, has learnt that is takes specialised expertise to make a notable difference in the lives of psychotic patients," explains Jacques Blaauw, Marketing Director for Lilly South Africa. "Through our partnership with Virgin Life Care, drug efficacy and tolerability can combine to improve patient functioning and help achieve better treatment outcomes," he says.

"This programme is tremendous. Firstly, many patients on anti-psychotic drugs suffer from schizophrenia which is a terrible mental condition affecting drive and ambition. This programme is excellent as it is an active intervention, primarily driven telephonically, whereby professionals such as dieticians and biokineticists will try to motivate patients to find and live as healthy lives as possible," comments Pretoria Psychiatrist, Dr Franco Colin. "Secondly, one side effect of being on an anti-psychotic medication can be weight gain, and this type of programme will help patients keep this in check," he says.

More than 1070 patients have been touched by the program with 330 active members currently on the Lilly Wellness Plus Programme. The programme has shown an 82% success rate for enrolled referrals.

What the programme entails:
What the patient on the Lilly Wellness Plus Programme benefits from:

• A personalised eating programme to manage their weight
• A personalised exercise programme that allows for exercise at home or in a gym
• Three months worth of weekly telephone coaching sessions with a dedicated biokineticist or dietician who acts as their personal wellness coach
• The next nine months is a maintenance programme, where the patient receives monthly calls from the coach to check progress and is encouraged to keep up good changes
• Their wellness coach will assist them in setting and achieving their health goals
• The wellness coach will track progress and make changes to the exercise or eating programme as needed
• The patient will be given useful content and tips that will make the programme fun and easy to follow
• In-bound telephonic support is available to patients from Monday to Friday between 08h00 and 17h00 on 0860 200 911
• The patient can nominate someone close to them who will be kept up to speed on their progress, and who will serve as their home support
• Quarterly progress reports will be sent to the referring psychiatrist
• Virgin Life Care will immediately notify the patient, the referring psychiatrist, should any abnormal behaviour changes in the patient be suspected during the coaching sessions
• The Lilly Wellness Plus programme is a proven health intervention that addresses the lifestyle challenges facing its patients.

For more information phone 0860 263 947.

References:
1. Bushe C, Haddad P, Peveler R et al. The role of lifestyle interventions and weight management in schizophrenia. Journal of Psychopharmacology 19(6) Supplement (2005) 28-35 2005
2. Morriss R, Mohammed FA. Metabolism, lifestyle and bipolar affective disorder. Journal of Psychopharmacology 19(6) Supplement (2005) 94-101 2005

(August 2008)