دورية أكاديمية
أعرض في EDS

Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial.

التفاصيل البيبلوغرافية
العنوان: Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial.
المؤلفون: Jebb SA; MRC Human Nutrition Research, Cambridge, UK. susan.jebb@mrc-hnr.cam.ac.uk, Ahern AL, Olson AD, Aston LM, Holzapfel C, Stoll J, Amann-Gassner U, Simpson AE, Fuller NR, Pearson S, Lau NS, Mander AP, Hauner H, Caterson ID
المصدر: Lancet (London, England) [Lancet] 2011 Oct 22; Vol. 378 (9801), pp. 1485-92. Date of Electronic Publication: 2011 Sep 07.
نوع المنشور: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 2985213R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1474-547X (Electronic) Linking ISSN: 01406736 NLM ISO Abbreviation: Lancet Subsets: MEDLINE
أسماء مطبوعة: Publication: 2004- : London : Elsevier
Original Publication: London : J. Onwhyn
مواضيع طبية MeSH: Commerce* , Referral and Consultation* , Weight Loss*, Obesity/*therapy , Overweight/*therapy, Adiposity ; Blood Glucose/analysis ; Blood Pressure ; Body Weight ; Female ; Humans ; Insulin/blood ; Lipids/blood ; Male ; Middle Aged ; Primary Health Care ; Waist Circumference
مستخلص: Background: The increasing prevalence of overweight and obesity needs effective approaches for weight loss in primary care and community settings. We compared weight loss with standard treatment in primary care with that achieved after referral by the primary care team to a commercial provider in the community.
Methods: In this parallel group, non-blinded, randomised controlled trial, 772 overweight and obese adults were recruited by primary care practices in Australia, Germany, and the UK. Participants were randomly assigned with a computer-generated simple randomisation sequence to receive either 12 months of standard care as defined by national treatment guidelines, or 12 months of free membership to a commercial programme (Weight Watchers), and followed up for 12 months. The primary outcome was weight change over 12 months. Analysis was by intention to treat (last observation carried forward [LOCF] and baseline observation carried forward [BOCF]) and in the population who completed the 12-month assessment. This trial is registered, number ISRCTN85485463.
Findings: 377 participants were assigned to the commercial programme, of whom 230 (61%) completed the 12-month assessment; and 395 were assigned to standard care, of whom 214 (54%) completed the 12-month assessment. In all analyses, participants in the commercial programme group lost twice as much weight as did those in the standard care group. Mean weight change at 12 months was -5·06 kg (SE 0·31) for those in the commercial programme versus -2·25 kg (0·21) for those receiving standard care (adjusted difference -2·77 kg, 95% CI -3·50 to -2·03) with LOCF; -4·06 kg (0·31) versus -1·77 kg (0·19; adjusted difference -2·29 kg, -2·99 to -1·58) with BOCF; and -6·65 kg (0·43) versus -3·26 kg (0·33; adjusted difference -3·16 kg, -4·23 to -2·11) for those who completed the 12-month assessment. Participants reported no adverse events related to trial participation.
Interpretation: Referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale.
Funding: Weight Watchers International, through a grant to the UK Medical Research Council.
(Copyright © 2011 Elsevier Ltd. All rights reserved.)
التعليقات: Comment in: Lancet. 2011 Oct 22;378(9801):1444-5. (PMID: 21906799)
Comment in: Lancet. 2012 Mar 17;379(9820):1003; author reply 1003. (PMID: 22423881)
Comment in: Internist (Berl). 2012 Aug;53(8):1002-4. (PMID: 22814564)
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معلومات مُعتمدة: MC_U105960384 United Kingdom MRC_ Medical Research Council; MC_U105960389 United Kingdom MRC_ Medical Research Council
سلسلة جزيئية: ISRCTN ISRCTN85485463
المشرفين على المادة: 0 (Blood Glucose)
0 (Insulin)
0 (Lipids)
تواريخ الأحداث: Date Created: 20110913 Date Completed: 20111115 Latest Revision: 20230104
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC3207352
DOI: 10.1016/S0140-6736(11)61344-5
PMID: 21906798
قاعدة البيانات: MEDLINE
الوصف
تدمد:1474-547X
DOI:10.1016/S0140-6736(11)61344-5