Evaluation of the counterweight

programme for obesity management in primary care: a starting point for continuous improvement (original) (raw)

Ross, H.M., Laws, R., Reckless, J. and Lean, M.E.J.(2008) Evaluation of the counterweight programme for obesity management in primary care: a starting point for continuous improvement.British Journal of General Practice, 58(553), pp. 548-554.

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Abstract

Background: Evaluation for obesity management in primary care is limited, and successful outcomes are from intensive clinical trials in hospital settings.Aim: To determine to what extent measures of success seen in intensive clinical trials can be achieved in routine primary care. Primary outcome measures were weight change and percentage of patients achieving ≤5% loss at 12 and 24 months.Design of study: Prospective evaluation of a new continuous improvement model for weight management in primary care.Setting: Primary care, UK.Method: Primary care practice nurses from 65 UK general practices delivered interventions to 1906 patients with body mass index (BMI) ≥30 kg/m2 or ≥28 kg/m2 with obesity-related comorbidities.Results: Mean baseline weight was 101.2 kg (BMI 37.1 kg/m2); 25% of patients had BMI ≥40 kg/m2 and 74% had ≥1 major obesity-related comorbidity. At final data capture 1419 patients were in the programme for ≥12 months, and 825 for ≥24 months. Mean weight change in those who attended and had data at 12 months (n = 642) was −3.0 kg (95% CI = −3.5 to −2.4 kg) and at 24 months (n = 357) was −2.3 kg (95% CI = −3.2 to −1.4 kg). Among attenders at specific time-points, 30.7% had maintained weight loss of ≥5% at 12 months, and 31.9% at 24 months. A total of 761 (54%) of all 1419 patients who had been enrolled in the programme for >12 months provided data at or beyond 12 months.Conclusion: This intervention achieves and maintains clinically valuable weight loss within routine primary care.

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