{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:48:42Z","timestamp":1792622922398,"version":"4.5.0"},"reference-count":79,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,10,15]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the occupational therapy (OT) interventions in adults with severe mental illness (SMI) most investigated in intervention studies and to describe their characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Scoping review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data sources<\/jats:title><jats:p>On 17 January 2020, we searched the following electronic databases: MEDLINE, Scopus, Web of Science and EMBASE. We also performed a manual search of TESEO doctoral thesis database and of the journals indexed in the first quartile of OT according to the SCImago Journal Rank. We updated our search on 10 March 2021, performing a complementary search on ProQuest database and repeating the search in all sources. The terms included in the search strategy were: schizophrenia, schizotypal personality, delusional, schizoaffective, psychotic, bipolar, major depression, obsessive\u2013compulsive, severe mental, OT and intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study selection<\/jats:title><jats:p>The study screening was peer-reviewed. Inclusion criteria were: (1) OT intervention studies in SMI: experimental, randomised, non-randomised and pilot\/exploratory studies; (2) adult population with SMI: schizophrenia, schizotypal personality disorder, delusional disorder, obsessive\u2013compulsive disorder, schizoaffective disorder, psychotic disorder, bipolar disorder, major depressive disorder; (3) OT identified as a discipline involved in the intervention; (4) English or Spanish language and (5) studies with full text available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty-five studies met the inclusion criteria. OT interventions were classified in psychosocial, psychoeducational, cognitive and exercise interventions. The most used OT intervention was psychosocial intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Psychosocial intervention was the most investigated OT intervention in SMI, followed by psychoeducational, cognitive and exercise interventions. These interventions are usually group interventions in patients with schizophrenia, performed by a multidisciplinary team (in which an occupational therapist collaborates), with 2\u20133 weekly 60\u2009min sessions and a duration of 3\u20136 months.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-047467","type":"journal-article","created":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T16:05:15Z","timestamp":1635523515000},"page":"e047467","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":36,"title":["Occupational therapy interventions for adults with severe mental illness: a scoping review"],"prefix":"10.1136","volume":"11","author":[{"given":"Mar\u00eda","family":"Rocamora-Montenegro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5324-1535","authenticated-orcid":false,"given":"Laura-Mar\u00eda","family":"Compa\u00f1-Gabucio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5742-2704","authenticated-orcid":false,"given":"Manuela","family":"Garcia de la Hera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"2024102817431344000_11.10.e047467.1","unstructured":"Instituto Nacional de Epidemiolog\u00eda de Salud Carlos III . Salud mental Y Salud P\u00fablica en Espa\u00f1a: Vigilancia epidemiol\u00f3gica, 2017. Available: http:\/\/publicaciones.isciii.es [Accessed 20 Nov 2019]."},{"key":"2024102817431344000_11.10.e047467.2","unstructured":"World Health Organization . International classification of impairments, disabilities and handicaps. Geneva: WHO, 1980."},{"key":"2024102817431344000_11.10.e047467.3","unstructured":"National Institute of Mental Health (NIMH) . Towards a model for a comprehensive community based mental health system, 1987. Available: https:\/\/www.nih.gov\/about-nih\/what-we-do\/nih-almanac\/national-institute-mental-health-nimh [Accessed 20 Nov 2019]."},{"key":"2024102817431344000_11.10.e047467.4","unstructured":"World Health Organization . The ICD-10 classification of mental and behavioral disorders. Clinical descriptions and diagnostic guidelines. WHO, 1992."},{"key":"2024102817431344000_11.10.e047467.5","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1080\/09638288.2018.1425744","article-title":"Motor skills, cognition, and work performance of people with severe mental illness","volume":"41","author":"Lipskaya-Velikovsky","year":"2019","journal-title":"Disabil Rehabil"},{"key":"2024102817431344000_11.10.e047467.6","doi-asserted-by":"crossref","first-page":"7205170010p1","DOI":"10.5014\/ajot.2018.725001","article-title":"Effectiveness of occupational therapy services in mental health practice","volume":"72","author":"Swarbrick","year":"2018","journal-title":"Am J Occup Ther"},{"key":"2024102817431344000_11.10.e047467.7","unstructured":"Diez-Carral B , Montoya-del-Corte P , Solana-\u00c1lvarez A . La atenci\u00f3n sociosanitaria a personas Con trastorno mental Grave: Una propuesta de red de dispositivos para Cantabria, 2015. Available: https:\/\/www.ascasam.org\/images\/interes\/TesinaMAGDS.pdf [Accessed 28 November 2019]."},{"key":"2024102817431344000_11.10.e047467.8","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/YCO.0000000000000339","article-title":"Occupational therapy interventions in the treatment of people with severe mental illness","volume":"30","author":"H\u00f6hl","year":"2017","journal-title":"Curr Opin Psychiatry"},{"key":"2024102817431344000_11.10.e047467.9","doi-asserted-by":"publisher","DOI":"10.3928\/15394492-20110819-01"},{"key":"2024102817431344000_11.10.e047467.10","unstructured":"Brown C , Stoffel V . Occupational therapy in mental health: a vision for participation. 2nd ed. Philadelphia: FA Davis, 2019."},{"key":"2024102817431344000_11.10.e047467.11","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s10597-020-00561-3","article-title":"Recovery in supported Accommodations: a scoping review and synthesis of interventions for people with severe mental illness","volume":"56","author":"Bitter","year":"2020","journal-title":"Community Ment Health J"},{"key":"2024102817431344000_11.10.e047467.12","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.58.4.466"},{"key":"2024102817431344000_11.10.e047467.13","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2011.001289"},{"key":"2024102817431344000_11.10.e047467.14","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/1440-1630.12575","article-title":"Occupational therapy intervention addressing weight gain and obesity in people with severe mental illness: a scoping review","volume":"66","author":"Conn","year":"2019","journal-title":"Aust Occup Ther J"},{"key":"2024102817431344000_11.10.e047467.15","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"2024102817431344000_11.10.e047467.16","unstructured":"Higgins J , Green S . Cochrane Handbook for systematic reviews of interventions. The Cochrane collaboration, 2011. Available: http:\/\/handbook.cochrane.org\/ [Accessed 16 February 2020]."},{"key":"2024102817431344000_11.10.e047467.17","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"2024102817431344000_11.10.e047467.18","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"2024102817431344000_11.10.e047467.19","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-017-0644-y","article-title":"Optimal database combinations for literature searches in systematic reviews: a prospective exploratory study","volume":"6","author":"Bramer","year":"2017","journal-title":"Syst Rev"},{"key":"2024102817431344000_11.10.e047467.20","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050140"},{"key":"2024102817431344000_11.10.e047467.21","doi-asserted-by":"publisher","DOI":"10.1191\/026921501678310153"},{"key":"2024102817431344000_11.10.e047467.22","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.2.144"},{"key":"2024102817431344000_11.10.e047467.23","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-005-9023-6"},{"key":"2024102817431344000_11.10.e047467.24","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291706009366"},{"key":"2024102817431344000_11.10.e047467.25","doi-asserted-by":"publisher","DOI":"10.1002\/oti.226"},{"key":"2024102817431344000_11.10.e047467.26","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.108.058263"},{"key":"2024102817431344000_11.10.e047467.27","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710001029"},{"key":"2024102817431344000_11.10.e047467.28","doi-asserted-by":"publisher","DOI":"10.1159\/000348448"},{"key":"2024102817431344000_11.10.e047467.29","doi-asserted-by":"publisher","DOI":"10.1007\/s00406-018-0916-0"},{"key":"2024102817431344000_11.10.e047467.30","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-017-1304-4"},{"key":"2024102817431344000_11.10.e047467.31","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s00406-017-0833-7","article-title":"Metacognitive training in patients recovering from a first psychosis: an experience sampling study testing treatment effects","volume":"268","author":"Pos","year":"2018","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"2024102817431344000_11.10.e047467.32","doi-asserted-by":"crossref","first-page":"e0193869","DOI":"10.1371\/journal.pone.0193869","article-title":"A multicenter, randomized controlled trial of individualized occupational therapy for patients with schizophrenia in Japan","volume":"13","author":"Shimada","year":"2018","journal-title":"PLoS One"},{"key":"2024102817431344000_11.10.e047467.33","doi-asserted-by":"crossref","first-page":"101702","DOI":"10.1016\/j.aip.2020.101702","article-title":"The healing effect of goal-oriented dance and movement therapy in schizophrenia: a rater-blinded randomized controlled trial","volume":"71","author":"G\u00f6kcen","year":"2020","journal-title":"Arts Psychother"},{"key":"2024102817431344000_11.10.e047467.34","first-page":"E119","article-title":"Effects of Home-visit occupational therapy using a management tool for daily life performance on severe mental illness: a multicenter randomized controlled trial","volume":"66","author":"Mashimo","year":"2020","journal-title":"Kobe J Med Sci"},{"key":"2024102817431344000_11.10.e047467.35","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1108\/14636646200600018","article-title":"A cognitive behavioural groupbased educational programme for psychotic symptoms in a low secure setting: a pilot evaluation","volume":"8","author":"Mclnnis","year":"2006","journal-title":"British Jnl Forensic Practice"},{"key":"2024102817431344000_11.10.e047467.36","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-008-0176-9"},{"key":"2024102817431344000_11.10.e047467.37","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3928\/02793695-20080701-08","article-title":"The effect of exercise on psychological & physical health outcomes: preliminary results from a Norwegian forensic hospital","volume":"46","author":"Tetlie","year":"2008","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"key":"2024102817431344000_11.10.e047467.38","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/oti.1436","article-title":"Influences of aerobic dance on cognitive performance in adults with schizophrenia","volume":"23","author":"Chen","year":"2016","journal-title":"Occup Ther Int"},{"key":"2024102817431344000_11.10.e047467.39","doi-asserted-by":"crossref","first-page":"189","DOI":"10.32381\/JPR.2018.13.01.18","article-title":"Assessment and management of Socio-Occupational functioning of persons with chronic schizophrenia: effect of social skills training","volume":"13","author":"Singh","year":"2018","journal-title":"JPR"},{"key":"2024102817431344000_11.10.e047467.40","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajp.2019.101896","article-title":"Is a program to improve grocery-shopping skills clinically effective in improving executive function and instrumental activities of daily living of patients with schizophrenia?","volume":"48","author":"Kim","year":"2020","journal-title":"Asian J Psychiatr"},{"key":"2024102817431344000_11.10.e047467.41","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-020-02924-2","article-title":"Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data","volume":"20","author":"Argentzell","year":"2020","journal-title":"BMC Psychiatry"},{"key":"2024102817431344000_11.10.e047467.42","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/0164212X.2019.1663336","article-title":"The outcome of two occupational therapy group programs on the social functioning of individuals with major depressive disorder","volume":"36","author":"Ramano","year":"2020","journal-title":"Occupational Therapy in Mental Health"},{"key":"2024102817431344000_11.10.e047467.43","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s11126-019-09679-4","article-title":"Effects of a Psychoeducation program for people with schizophrenia aimed at increasing subjective well-being and the factors influencing those effects: a preliminary study","volume":"91","author":"Shinozaki","year":"2020","journal-title":"Psychiatr Q"},{"key":"2024102817431344000_11.10.e047467.44","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1080\/0164212X.2020.1845276","article-title":"Comparing Narrative-Informed occupational therapy in adult outpatient mental health to treatment as usual: a quasi-experimental feasibility study with preliminary treatment outcomes","volume":"37","author":"Wasmuth","year":"2021","journal-title":"Occupational Therapy in Mental Health"},{"key":"2024102817431344000_11.10.e047467.45","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1037\/h0095216","article-title":"Group effectiveness in improving social interaction skills","volume":"22","author":"Schindler","year":"1999","journal-title":"Psychiatr Rehabil J"},{"key":"2024102817431344000_11.10.e047467.46","doi-asserted-by":"publisher","DOI":"10.1177\/153944920102100301"},{"key":"2024102817431344000_11.10.e047467.47","doi-asserted-by":"publisher","DOI":"10.2975\/29.2006.267.273"},{"key":"2024102817431344000_11.10.e047467.48","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1016\/j.psychres.2018.10.037","article-title":"An efficacy study of a metacognitive group intervention for people with schizophrenia","volume":"270","author":"Kaizerman-Dinerman","year":"2018","journal-title":"Psychiatry Res"},{"key":"2024102817431344000_11.10.e047467.49","first-page":"248","article-title":"Effect of adjunct psychosocial skills training on social functioning of schizophrenia patients who get occupational therapy in a community mental health center: a comparative study","volume":"57","author":"Karaman","year":"2020","journal-title":"Noro Psikiyatr Ars"},{"key":"2024102817431344000_11.10.e047467.50","doi-asserted-by":"publisher","DOI":"10.1080\/01642120802644904"},{"key":"2024102817431344000_11.10.e047467.51","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2011.001313"},{"key":"2024102817431344000_11.10.e047467.52","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1742-7924.2012.00211.x","article-title":"Occupational therapy for inpatients with chronic schizophrenia: a pilot randomized controlled trial","volume":"10","author":"Foruzandeh","year":"2013","journal-title":"Jpn J Nurs Sci"},{"key":"2024102817431344000_11.10.e047467.53","doi-asserted-by":"publisher","DOI":"10.1177\/0269215514521440"},{"key":"2024102817431344000_11.10.e047467.54","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.psychres.2016.05.011","article-title":"A pilot randomized controlled trial of the occupational goal intervention method for the improvement of executive functioning in patients with treatment-resistant schizophrenia","volume":"245","author":"Vizzotto","year":"2016","journal-title":"Psychiatry Res"},{"key":"2024102817431344000_11.10.e047467.55","unstructured":"World Federation of Occupational Therapists (WFOT) . History. Available: https:\/\/wfot.org\/about\/history [Accessed 30 March 2021]."},{"key":"2024102817431344000_11.10.e047467.56","unstructured":"Trivi\u00f1\u00f3 Ju\u00e1rez JM , Romero Ayuso DM . Institucionalizaci\u00f3n de la terapia ocupacional en Espa\u00f1a. In: Romero Ayuso DM , Moruno Miralles P , eds. Terapia ocupacional: Teor\u00eda Y t\u00e9cnicas. Barcelona: Masson, 2003: 29\u201340."},{"key":"2024102817431344000_11.10.e047467.57","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2011.001297"},{"key":"2024102817431344000_11.10.e047467.58","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2017.04.003"},{"key":"2024102817431344000_11.10.e047467.59","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/YCO.0000000000000618","article-title":"Psychosocial therapies in severe mental illness: update on evidence and recommendations","volume":"33","author":"G\u00fchne","year":"2020","journal-title":"Curr Opin Psychiatry"},{"key":"2024102817431344000_11.10.e047467.60","doi-asserted-by":"publisher","DOI":"10.2975\/32.3.2009.155.161"},{"key":"2024102817431344000_11.10.e047467.61","doi-asserted-by":"publisher","DOI":"10.1016\/j.eurpsy.2010.12.005"},{"key":"2024102817431344000_11.10.e047467.62","doi-asserted-by":"crossref","first-page":"622061","DOI":"10.3389\/fpsyt.2020.622061","article-title":"iPS in supported housing: fidelity and employment outcomes over a 4 year period","volume":"11","author":"Roeg","year":"2020","journal-title":"Front Psychiatry"},{"key":"2024102817431344000_11.10.e047467.63","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-020-02745-3","article-title":"An enhanced individual placement and support (iPS) intervention based on the model of human occupation (MOHO); a prospective cohort study","volume":"20","author":"Prior","year":"2020","journal-title":"BMC Psychiatry"},{"key":"2024102817431344000_11.10.e047467.64","doi-asserted-by":"crossref","first-page":"743","DOI":"10.30994\/sjik.v9i2.373","article-title":"Vocational rehabilitation based recovery of patients with mental disorders (ODGJ)","volume":"9","author":"Akasyah","year":"2020","journal-title":"Sjik"},{"key":"2024102817431344000_11.10.e047467.65","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-021-03140-2","article-title":"Acute day units for mental health crises: a qualitative study of service user and staff views and experiences","volume":"21","author":"Morant","year":"2021","journal-title":"BMC Psychiatry"},{"key":"2024102817431344000_11.10.e047467.66","doi-asserted-by":"publisher","DOI":"10.1177\/0269215512473136"},{"key":"2024102817431344000_11.10.e047467.67","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-009-0114-5"},{"key":"2024102817431344000_11.10.e047467.68","doi-asserted-by":"publisher","DOI":"10.3233\/WOR-2010-1057"},{"key":"2024102817431344000_11.10.e047467.69","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1111\/1440-1630.12238","article-title":"Recovery as an occupational journey: a scoping review exploring the links between occupational engagement and recovery for people with enduring mental health issues","volume":"62","author":"Doroud","year":"2015","journal-title":"Aust Occup Ther J"},{"key":"2024102817431344000_11.10.e047467.70","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/ijtr.2016.0070","article-title":"Occupational therapy interventions in mental health: a scoping review of recent evidence","volume":"26","author":"Petersen","year":"2019","journal-title":"Int J Ther Rehabil"},{"key":"2024102817431344000_11.10.e047467.71","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.schbul.a033379"},{"key":"2024102817431344000_11.10.e047467.72","doi-asserted-by":"crossref","first-page":"95","DOI":"10.12809\/eaap1970","article-title":"Activity participation and perceived health status in patients with severe mental illness: a prospective study","volume":"30","author":"Ng","year":"2020","journal-title":"East Asian Arch Psychiatry"},{"key":"2024102817431344000_11.10.e047467.73","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-018-1832-6","article-title":"Using motivational techniques to reduce cardiometabolic risk factors in long term psychiatric inpatients: a naturalistic interventional study","volume":"18","author":"Ringen","year":"2018","journal-title":"BMC Psychiatry"},{"key":"2024102817431344000_11.10.e047467.74","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3389\/fpsyt.2020.00319","article-title":"Feasibility and acceptability of a student-led lifestyle (diet and exercise) intervention within a residential rehabilitation setting for people with severe mental illness, go heart (group occupation, health, exercise and rehabilitation treatment)","volume":"11","author":"Korman","year":"2020","journal-title":"Front Psychiatry"},{"key":"2024102817431344000_11.10.e047467.75","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(94)90093-0"},{"key":"2024102817431344000_11.10.e047467.76","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajp.2021.102601","article-title":"Reducing the stigma of mental health disorders with a focus on low- and middle-income countries","volume":"58","author":"Javed","year":"2021","journal-title":"Asian J Psychiatr"},{"key":"2024102817431344000_11.10.e047467.77","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l295"},{"key":"2024102817431344000_11.10.e047467.78","unstructured":"World Health Organization . Helping people with severe mental disorders live longer and healthier lives: policy brief. WHO, 2017."},{"key":"2024102817431344000_11.10.e047467.79","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1655"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-047467","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:52:36Z","timestamp":1730163156000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-047467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":79,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,29]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bmjopen-2020-047467"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-047467","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}