The SOFIA pilot study: assessing feasibility and fidelity of coordinated care to reduce excess mortality and increase quality of life in patients with severe mental illness in a general practice setting; a cluster-randomised pilot trial

ObjectiveTo evaluate the feasibility and fidelity of implementing and assessing the SOFIA coordinated care program aimed at lowering mortality and increasing quality of life in patients with severe mental illness by improving somatic health care in general practice.DesignA cluster-randomised, non-blinded controlled pilot trial.SettingGeneral Practice in Denmark.InterventionThe SOFIA coordinated care program comprised extended structured consultations carried out by the GP, group-based training of GPs and staff, and a handbook with information on signposting patients to relevant municipal, health, and social initiatives.PatientsPersons aged 18 years or older with a diagnosis of psychotic, bipolar, or severe depressive disorder.Main outcome measuresWe collected quantitative data on the delivery, recruitment and retention rates of practices and patients, and response rates of questionnaires MMQ and EQ-5D-5 L.ResultsFrom November 2020 to March 2021, nine practices were enrolled and assigned in a 2:1 ratio to the intervention group (n = 6) or control group (n = 3). Intervention group practices included 64 patients and Control practices included 23. The extended consultations were delivered with a high level of fidelity in the general practices; however, thresholds for collecting outcome measures, and recruitment of practices and patients were not reached.ConclusionOur findings suggest that delivering the coordinated care program in a fully powered trial in primary care is likely feasible. However, the recruitment methodology requires improvement to ensure sufficient recruitment and minimize selective inclusion.Trial registrationThe date of pilot trial protocol registration was 05/11/2020, and the registration number is NCT04618250.

Automated summary

This study evaluated the feasibility and fidelity of implementing and assessing the SOFIA coordinated care program in general practice in Denmark, aimed at improving somatic health care for patients with severe mental illness. While the program was implemented with a high level of fidelity, improvements are needed in the recruitment methodology.