A Novel Multidisciplinary Intervention for Long-Term Weight Loss and Glycaemic Control in Obese Patients with Diabetes

Lih, Anna; Pereira, Lorraine; Bishay, Ramy H; Zang, Johnson; Omari, Abdullah; Atlantis, Evan; Kormas, Nic

doi:10.1155/2015/729567

Cited by 23 publications

(51 citation statements)

References 37 publications

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“…Utilization of intensive interventions in isolation was rare, and the greatest proportion of clinically significant weight loss was observed when allied health and intensive interventions were combined. This is consistent with previous research where multidisciplinary approaches to behavioural interventions were shown to yield greater long‐term weight loss and improvement in particular metabolic profiles in patients with comorbid obesity and T2DM . It could therefore be argued that a lower threshold for augmenting multiple treatment modalities at an earlier stage of obesity management would optimize patient outcomes.…”

Section: Discussionsupporting

confidence: 89%

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Brightman¹,

Hsu

Dugdale

2019

Clinical Obesity

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Summary Multi‐disciplinary specialist services have a crucial role in the management of patients with obesity. As demand for these services increases, so too does the need to monitor individual service performance and compare outcomes across multiple sites. This paper reports on results from the publicly funded Canberra Obesity Management Service. A descriptive observational study was conducted on new patients who attended an initial medical review from July 2016 to June 2017. Baseline characteristics, comorbidities, attendance, service utilization and outcomes were collated until June 2018. Of the 162 patients identified, 64% continued to attend beyond initial medical review. Dietetics was the most commonly accessed allied health service, followed by exercise physiology and psychology. Very low‐energy diet was the most commonly trialled intensive intervention, followed by pharmacotherapy and bariatric surgery. Mean baseline weight for those who continued beyond initial medical review was 142.0 kg (SD 26.6 kg), with a mean weight change of −6.2 kg (SD 10.2 kg) and a mean change in percentage body weight of −5% (SD 7%). Clinically significant weight loss was achieved in 36% of these patients, with a further 47% achieving weight stabilization. Mean Depression, Anxiety and Stress Scale scores reduced from 8‐6‐8 to 7‐5‐5, and mean Epworth Sleepiness Scale scores decreased from 8/24 to 6/24. Polysomnography referrals were made for 37% of all new patients, 87% of whom were diagnosed with varying degrees of obstructive sleep apnoea. We present these findings in the hope that they may serve as an example for data collection, individual service monitoring and comparison across multiple obesity services.

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Section: Discussionsupporting

confidence: 89%

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Brightman¹,

Hsu

Dugdale

2019

Clinical Obesity

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“…We previously described the integrated model of the multidisciplinary MRP in detail [19,20]. Briefly, the MRP commenced study enrollment of patients from 2007 to 2011 who fulfilled two criteria: (1) BMI > 35 kg/m 2 ; (2) and a diagnosis of T2DM.…”

Section: Metabolic Rehabilitation Programmentioning

confidence: 99%

Self-Empowerment and Health Outcomes in Obese Adults with Type 2 Diabetes Following Completion of a Multi-Disciplinary Metabolic Rehabilitation Program

RH¹

2017

EMIJ

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“…The MRP is a comprehensive and intensive lifestyle treatment programme for managing patients with complex and severe obesity using an integrated physician‐led MDT care model, which is consistent with the model of care recommended in our recently published expert consensus . There were two MRP clinics available to patients who had either diabetes or fatty liver disease.…”

Section: Methodsmentioning

confidence: 88%

“…Clinical obesity services variably provide physician‐led multidisciplinary team (MDT) care utilizing intensive lifestyle interventions, psychological support, weight‐loss pharmacotherapies, as well as bariatric surgery when indicated and where feasible . There is an evidence of effectiveness of clinical obesity services including non‐surgical MDT care, weight‐loss pharmacotherapies, and bariatric surgery for improving a range of health outcomes in patients with clinically severe obesity (defined as BMI ≥40 or ≥35 kg/m 2 with at least one complication) . Controlled studies suggest that patients with severe obesity typically lose approximately 6% of their initial body weight after 12 months of non‐surgical clinical obesity services …”

Section: Introductionmentioning

confidence: 99%

Physical capacity outcomes in patients with severe obesity after 12 months of physician‐led multidisciplinary team care: A case series from a public hospital clinical obesity service

et al. 2019

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Summary Impaired physical capacity is common in people with severe levels of obesity. We aimed to investigate changes in physical capacity outcomes in patients with severe obesity following 12 months of physician‐led multidisciplinary care from a “real world” Australian public hospital setting using a case series study design. We extracted data from medical records for all of the eligible patients referred to our clinical obesity service from 2010 to 2015 (69 of 239). We found significant (P < .05) pre‐test/post‐test (mean ± SD) improvements in the 6‐minute walk test (6MWT) (339 ± 120 to 417 ± 112 m); 30‐second sit‐to‐stand test (11 ± 4 to 15 ± 6 counts) and sit‐and‐reach test (−12 ± 13 to −8 ± 15 cm). Using linear mixed‐effects models adjusting for repeated measurements over time (baseline vs 12 months) and testing for potential predictors, we found: mean 6MWT was associated with 12‐month time period (56 m), body mass index (BMI, −3 m), no walking aid over 12 months (106 m) and no opioid analgesics (75 m); mean sit‐to‐stand was associated with 12‐month time period (3 counts), age at referral (−0.2 counts), BMI (−0.2 counts), and diabetes (3 counts); and mean sit‐and‐reach was associated with 12‐month time period (5 cm), female gender (5 cm) and total medications (−0.9 cm). Using causal mediation analysis, our results show that total exercise classes partially mediates change in walking capacity among those with cardiovascular disease. Our study shows that significant and clinically important improvements in physical capacity outcomes in patients with severe obesity can be achieved following 12 months of intensive specialist obesity services, such as ours.

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A Novel Multidisciplinary Intervention for Long-Term Weight Loss and Glycaemic Control in Obese Patients with Diabetes

Cited by 23 publications

References 37 publications

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Determining patient attendance, access to interventions and clinical outcomes in a publicly funded obesity programme: Results from the Canberra Obesity Management Service

Self-Empowerment and Health Outcomes in Obese Adults with Type 2 Diabetes Following Completion of a Multi-Disciplinary Metabolic Rehabilitation Program

Physical capacity outcomes in patients with severe obesity after 12 months of physician‐led multidisciplinary team care: A case series from a public hospital clinical obesity service

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