Cardiometabolic Health of People with Severe and Persistent Mental Illness (2016–2019)
People with schizophrenia have much higher rates of mortality and morbidity than the general population, with the majority of the physical health illness burden due to cardio-metabolic disease. Smoking and obesity/type 2 diabetes (T2DM) are the major modifiable risk factors. This research program aims to conduct parallel pilot clinical trials of interventions for a) obesity/T2DM and b) smoking, for people with schizophrenia. Trial a) is an open label randomised controlled pilot study to investigate the efficacy of once weekly subcutaneous exenatide to decrease weight and/or improve glycaemic control in people with schizophrenia with obesity +/- poorly controlled T2DM, and to gather pilot data on adherence and safety in clinical settings (funding for project secured and project commenced). I hypothesise that, as clozapine interferes with GLP-1 production in the gut to cause glucose dysregulation, then a GLP-1 agonist may reverse this adverse effect. Trial b) is a pilot study to examine the acceptability and efficacy of adding a tobacco harm reduction intervention of vaporised nicotine products for nicotine replacement therapy (VNP-NRT) to standard care for smokers with schizophrenia (funding for site 1 secured). I hypothesise that, as people with schizophrenia may self medicate with nicotine, then VNP-NRT will be more effective that quit programs alone to reduce smoking. I plan to use data from these pilot studies to seek NHMRC Project Grant and other funding for multi-centre RCTs. Research into effective treatments for obesity/diabetes and smoking is of direct translational importance to psychiatric clinical practice and has the potential to reduce mortality and morbidity in people with schizophrenia.