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Evaluating interventions to reduce cardiovascular disease risk in people living with severe mental illness (UCLP PRIMROSE-A)

National ARC Projects 

Evaluating implementation of a framework for identification and tailored CVD prevention intervention (UCLP PRIMROSE-A) for people with serious mental illness

Lead: NIHR ARC North Thames

Why the research is needed?

People with severe mental illness experience some of the most profound health inequalities and this is a NHS Long term plan priority.  Multi-morbidity drives this inequality; with the coexistence of multiple long-term conditions (such as diabetes and heart disease), which are potentially modifiable.  This project builds on ten years of NIHR research and a strong collaboration between YH-ARC and ARC–North Thames.

What we will do?

In our research to date (known as the PRIMROSE programme) we have shown that by optimizing the management of cardiovascular disease (CVD) and CVD risk factors we can reduce healthcare costs and admission.  We propose to build on this evidence and model of care by incorporating the latest evidence-based frameworks for CVD risk factors. PRIMROSE-A (Adapted) is an improved version of the intervention, modified to include more social support via peer coaches, and increased focus on medication adherence (e.g. statins). It is currently being delivered in Camden, Inner London (2019-20). We plan to extend implementation in the North Thames region and Yorkshire/Humber region.

UCLP has evidence based Long Term Condition frameworks which have traction nationally. These frameworks will now update and augment PRIMROSE-A with implementation in the two regions. Both regions have major health inequalities and ethnically diverse populations.

People with lived experience of serious mental illnesses have been at the centre of our work (with national recognition) and this will be strengthened by our cross-ARC collaboration.  We will work with local NHS organizations and the voluntary sectors to maximize chances of our success. 

What will be achieved?

We will use best implementation practice in the new settings so that the PRIMROSE-A programme has the best chance of benefitting people. We will evaluate the implementation to provide the evidence to support wider implementation and sustainability in other regions.

When the findings will be available? 

January 2024

Collaborating ARCs:

  • NIHR ARC Yorkshire and Humber

Other Collaborating Institutions for Implementation:

  • UCL Partners AHSN
  • Yorkshire and Humber Improvement Academy

Contribution to National Priority Aims:

Cross-regional implementation of an intervention with evidenced potential to reduce the burden of multiple long-term conditions (multimorbidity).

Websites for further Primrose information:

Project summary on ARC North Thames website 

UCL Primrose website

Contact: Professor David Osborn,