Outcomes of a specialist weight management programme in the UK National Health Service: prospective study of 1838 patients
Outcomes of a specialist weight management programme in the UK National Health Service: prospective study of 1838 patients
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DOI：
10.1136/bmjopen-2013-003747
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发表时间：
2014-01-01
期刊：
影响因子：
2.9
通讯作者：
Morrison, David S.
中科院分区：
文献类型：
--
作者：
Logue, Jennifer;Allardice, Gwen;Morrison, David S.
目的：在常规医疗保健中提供的体重管理计划的有效性证据有限，结果测量的使用不一致。我们的目的是评估一个大型的国民健康服务（NHS）体重管理服务，并报告12个月内的绝对和比例体重减轻。设计前瞻性观察研究。设置格拉斯哥和克莱德体重管理服务（GCWMS），为大格拉斯哥和克莱德地区的居民提供医疗服务参与者在2008年10月1日至2009年9月30日期间开始GCWMS的所有患者。干预采用认知行为疗法，600千卡饮食，体力活动建议，低热量饮食和药物治疗。主要和次要结果测量基线观察结转（BOCF），末次观察结转（LOCF）和计划完成者的变化，使用绝对5 kg和5%体重减轻的结果和各种时间点的平均体重变化报告。结果6505例转诊至GCWMS，5637例合格，3460人选择参加，1916人（34%）参加了第一次会议。78例患者从我们对1838例患者的分析中排除。72.9%的患者为女性，基线时所有患者的平均年龄为49.1岁，43.3%生活在社会经济高度贫困地区，基线时平均体重和体重指数分别为118.1kg和43.3kg/m2。第1阶段结束时，26%的患者体重减轻5 kg，第2阶段结束时为30%，第3阶段结束时为28%（所有LOCF）。减肥是更成功的男性，特别是那些29 years old.Conclusions常规NHS体重管理服务可以实现适度的体重减轻，通过一个全面的循证饮食，活动和行为的方法，包括心理护理。应使用一系列结果测量报告体重减轻，以便比较不同服务的有效性。
Objectives There is limited evidence on the effectiveness of weight management programmes provided within routine healthcare and inconsistent use of outcome measures. Our aim was to evaluate a large National Health Service (NHS) weight management service and report absolute and proportional weight losses over 12months.Design Prospective observational study.Setting Glasgow and Clyde Weight Management Service (GCWMS), which provides care for residents of NHS Greater Glasgow and Clyde area (population 1.2 million).Participants All patients who began GCWMS between 1 October 2008 and 30 September 2009.Interventions Structured educational lifestyle programme employing cognitive behavioural therapy, 600kcal deficit diet, physical activity advice, lower calorie diet and pharmacotherapy.Primary and secondary outcomes measures Baseline observation carried forward (BOCF), last observation carried forward (LOCF) and changes in programme completers reported using outcomes of absolute 5kg and 5% weight losses and mean weight changes at a variety of time points.Results 6505 referrals were made to GCWMS, 5637 were eligible, 3460 opted in and 1916 (34%) attended a first session. 78 patients were excluded from our analysis on 1838 patients. 72.9% of patients were women, mean age of all patients at baseline was 49.1years, 43.3% lived in highly socioeconomically deprived areas and mean weights and body mass indices at baseline were 118.1kg and 43.3kg/m(2), respectively. 26% lost 5kg by the end of phase 1, 30% by the end of phase 2 and 28% by the end of phase 3 (all LOCF). Weight loss was more successful among men, particularly those 29years old.Conclusions Routine NHS weight management services may achieve moderate weight losses through a comprehensive evidence-based dietary, activity and behavioural approach including psychological care. Weight losses should be reported using a range of outcome measures so that the effectiveness of different services can be compared.