{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:08:11Z","timestamp":1789020491701,"version":"build-2803163510"},"reference-count":49,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec id=\"S2056472426120973_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Weight gain is a common, distressing side-effect of antipsychotic medication prescribed for people with severe mental illness. National guidance for antipsychotic-induced weight gain (AIWG) encourages early intervention and physical health monitoring; healthcare professionals (HCPs) often struggle to implement these recommendations in routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120973_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To explore how HCPs understand and respond to AIWG for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120973_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This realist evaluation, part of the RESOLVE project, builds on a realist synthesis. Thirty HCPs participated in realist interviews. A programme theory with nine context\u2013mechanism\u2013outcome configurations (CMOCs) was generated, explaining how HCPs perceive non-pharmacological care provision for patients with AIWG. Clinical and lived experience stakeholders reviewed and refined the theory and CMOCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120973_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The nine CMOCs spanned three areas: (a) systemic and professional challenges; (b) strategies to enhance individualised and meaningful support; and (c) the role and limitations of non-professional support. HCPs described how lack of training, siloed services and system-level constraints limited their ability to offer integrated care. They highlighted the importance of relational continuity, early and tailored conversations, and alignment with patients\u2019 values and motivations. Peer and family support were valued, but structural barriers undermined their consistent implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426120973_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AIWG was experienced as compromising professional values for HCPs working in mental health settings. Person-centred care was often undermined by fragmented systems, role ambiguity and insufficient training. These issues require investment in professional development, structural integration, and relationship-based approaches that support timely, collaborative action.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.12097","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:00:08Z","timestamp":1789020008000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare professional perspectives on antipsychotic-induced weight gain: realist evaluation from the RESOLVE study"],"prefix":"10.1192","volume":"12","author":[{"given":"Jo","family":"Howe","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05j0ve876","id-type":"ROR","asserted-by":"publisher"}],"name":"Aston University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"MacPhee","sequence":"additional","affiliation":[{"name":"The University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsah","family":"Habib","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05j0ve876","id-type":"ROR","asserted-by":"publisher"}],"name":"Aston University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Wong","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-9536","authenticated-orcid":false,"given":"Sherifat","family":"Oduola","sequence":"additional","affiliation":[{"name":"University of East Anglia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabel E. L.","family":"Walsh","sequence":"additional","affiliation":[{"name":"McPin Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Higgs","sequence":"additional","affiliation":[{"name":"University of Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Allen","sequence":"additional","affiliation":[{"name":"Birmingham and Solihull Mental Health NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kenny","sequence":"additional","affiliation":[{"name":"McPin Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Lovell","sequence":"additional","affiliation":[{"name":"McPin Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Ahern","sequence":"additional","affiliation":[{"name":"University of Cambridge"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Carlish","sequence":"additional","affiliation":[{"name":"Birmingham and Solihull Mental Health NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Upthegrove","sequence":"additional","affiliation":[{"name":"University of Oxford"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurkiran","family":"Birdi","sequence":"additional","affiliation":[{"name":"Newman University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-9704","authenticated-orcid":false,"given":"Ian D.","family":"Maidment","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05j0ve876","id-type":"ROR","asserted-by":"publisher"}],"name":"Aston University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"S2056472426120973_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30416-X"},{"key":"S2056472426120973_ref19","doi-asserted-by":"publisher","DOI":"10.4135\/9781483348896.n29"},{"key":"S2056472426120973_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13734"},{"key":"S2056472426120973_ref32","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12266"},{"key":"S2056472426120973_ref12","volume-title":"The Maudsley Prescribing Guidelines in Psychiatry","author":"Taylor","year":"2025"},{"key":"S2056472426120973_ref2","article-title":"Antipsychotic-induced weight gain in psychosis: causal mediation analysis and feasibility study of causal actionable prediction model development using counterfactuals to target obesity","author":"Leighton","journal-title":"Br J Psychiatry"},{"key":"S2056472426120973_ref13","unstructured":"13 NHS England. Improving Physical Health of People with Serious Mental Illness: Guidance for Integrated Care Systems . 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Weight Management & Mental Health: A Framework for Action in Wales . Royal College of Psychiatrists, 2025 (https:\/\/www.rcpsych.ac.uk\/improving-care\/public-mental-health-implementation-centre\/weight-management-and-mental-health--a-framework-for-action-in-wales)."},{"key":"S2056472426120973_ref5","article-title":"Pharmacological interventions to manage cardiometabolic outcomes in adults with severe mental illness: umbrella review","author":"Carolan","journal-title":"Br J Psychiatry"},{"key":"S2056472426120973_ref27","first-page":"27","article-title":"Modified 5 As","volume":"59","author":"Vallis","year":"2013","journal-title":"Can Fam Physician"},{"key":"S2056472426120973_ref10","unstructured":"10 NHS England. Quality and Outcomes Framework Guidance for 2025\/26 . 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Psychosis and Schizophrenia in Adults: Prevention and Management. Clinical Guideline [CG178] . NICE, 2014 (https:\/\/www.nice.org.uk\/guidance\/cg178)."},{"key":"S2056472426120973_ref34","first-page":"CD009531","article-title":"Collaborative care approaches for people with severe mental illness","volume":"7","author":"Reilly","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"S2056472426120973_ref14","unstructured":"14 World Health Organization (WHO). Mental Health Gap Action Programme (mhGAP) Guideline for Mental, Neurological and Substance Use Disorders . WHO, 2023 (https:\/\/www.who.int\/publications\/i\/item\/9789240084278)."},{"key":"S2056472426120973_ref26","doi-asserted-by":"publisher","DOI":"10.1177\/1356389016638615"},{"key":"S2056472426120973_ref24","doi-asserted-by":"publisher","DOI":"10.1136\/ebnurs-2025-104289"},{"key":"S2056472426120973_ref36","doi-asserted-by":"publisher","DOI":"10.2147\/JHL.S396659"},{"key":"S2056472426120973_ref6","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13962"},{"key":"S2056472426120973_ref45","doi-asserted-by":"publisher","DOI":"10.1111\/inm.12503"},{"key":"S2056472426120973_ref35","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20136300"},{"key":"S2056472426120973_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/ebnurs-2025-104288"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472426120973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:00:12Z","timestamp":1789020012000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472426120973\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":49,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["S2056472426120973"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2026.12097","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e236"}}