Evaluating the management of obesity in UK primary care

评估英国初级保健中的肥胖管理

• 批准号: 2597917
• 金额: --
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2021
• 资助国家: 英国
• 起止时间: 2021 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2597917
• 关键词: Evaluating; management; obesity; UK; primary

The context of the research: With the majority of the UK population living with obesity and its complications, weight management is a momentous task for public health and primary care. Unlike other lifestyle related chronic conditions whose monitoring and management have been incentivised through the Quality of Outcomes Framework indicators since 2004, the management of obesity has not been promptly prioritised in a similar fashion. Despite reluctance from the British Medical Association in 2020, the National Health Service (NHS) has now introduced a policy in 2021 to monetise referrals to weight management programmes in primary care. Its aims and objectives: The aim of this project is to understand the impact of the National Enhanced Service Incentive (NESI) on weight management in UK general surgeries. Using a mixed methods approach, impact will be gauged by observing changes in the number of referrals, weight management advice given, weight, blood sugar, blood pressure, incidence of mental health, and changes in the perceptions, attitudes, and thoughts on weight management by primary care staff on the heels of the implementation of NESI. Its potential applications and benefits: A proximal benefit of this project is the collaboration with key stakeholders for simultaneous evaluation and implementation. Through this work, we will provide direct feedback to the NHS as we evaluate the policy in close collaboration with their implementation team, to potentially refine the scheme as it is rolled out. More distally, this work will provide insight into the utility of national programmes aiming to incentivise weight management, which may influence future policy. Additionally, this project ties in four of the MRC-UKRI's seven strategic priorities; 1) prevention and early detection, 2), multimorbidities, 3) precision medicine and 4) mental health, which collectively support excellent discovery science to improve human health. To begin with the first two themes, weight management falls within the remit of prevention, by targeting an upstream cause of ill-health, which can pre-empt the risk factors of obesity such as diabetes, cardiovascular disease and certain cancers, and we will evaluate the impact on comorbidities using big data. Thirdly, the NESI scheme recognises the individuality of the patient, allowing for choice in selecting the weight management programme to meet their unique needs, and we hope to understand the importance of this feature from the patient perspective. Finally, we assume a biopsychosocial approach in our evaluation, and recognise the correlation between mental health and obesity. We will be curious to see the influence of increased engagement with weight management, and how this may influence mental health, namely anxiety and depression.

研究背景：由于英国大多数人口患有肥胖症及其并发症，体重管理是公共卫生和初级保健的一项重要任务。自2004年以来，通过成果质量框架指标激励监测和管理的其他生活方式相关慢性病不同，肥胖症的管理没有以类似的方式迅速优先考虑。尽管英国医学会在2020年不情愿，但英国国民医疗服务体系（NHS）现在已经在2021年推出了一项政策，将初级保健中的体重管理计划货币化。其宗旨和目标：该项目的目的是了解英国普通外科手术中国家增强服务激励（NESI）对体重管理的影响。使用混合方法的方法，将通过观察转诊数量的变化，体重管理建议，体重，血糖，血压，心理健康的发生率，以及在实施NESI后初级保健人员对体重管理的看法，态度和想法的变化来衡量影响。其潜在的应用和好处：该项目的一个近期好处是与主要利益攸关方合作，同时进行评估和实施。通过这项工作，我们将提供直接反馈给国民保健服务，因为我们评估的政策与他们的实施团队密切合作，以潜在的完善计划，因为它是推出。更远的是，这项工作将深入了解旨在激励体重管理的国家计划的效用，这可能会影响未来的政策。此外，该项目与MRC-UKRI的七个战略重点中的四个有关：1）预防和早期发现，2）多病，3）精准医学和4）心理健康，这些都支持卓越的发现科学以改善人类健康。从前两个主题开始，体重管理福尔斯属于预防范围，通过针对健康不良的上游原因，可以预先消除肥胖的风险因素，如糖尿病，心血管疾病和某些癌症，我们将使用大数据评估对合并症的影响。第三，NESI计划承认患者的个性，允许选择体重管理计划以满足他们的独特需求，我们希望从患者的角度了解这一特点的重要性。最后，我们在评估中采用生物心理社会方法，并认识到心理健康与肥胖之间的相关性。我们将好奇地看到增加参与体重管理的影响，以及这如何影响心理健康，即焦虑和抑郁。