Improving health professionals' management and the organisation of care for overweight and obese people

Harvey, Emma; Glenny, Anne‐Marie; Kirk, Sara; Summerbell, Carolyn

doi:10.1002/14651858.cd000984

Cited by 52 publications

(56 citation statements)

References 123 publications

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“…[5][6][7][8][9][10][11][12][13] One meta-analysis has suggested that low-cost bibliotherapy programs produce weight-loss results as good as those achieved in clinic-based therapies. 14 Overall, however, as noted in a recent review of obesity treatment options in medical care settings, 15 no conclusions about the effectiveness of such treatments are possible at this time, and there is a need for larger and better designed studies in the area.…”

Section: Introductionmentioning

confidence: 99%

Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes

et al. 2003

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OBJECTIVE:To describe methods, recruitment success, and 1-y results of a study evaluating the effectiveness of phone-and mail-based weight-loss interventions in a managed care setting. DESIGN: Randomized clinical trial with three groups, that is, usual care, mail intervention, and phone intervention. SUBJECTS: In total, 1801 overweight members of a managed-care organization (MCO). MEASUREMENTS: Height, weight, medical status, and weight-loss history were measured at baseline. Participation in intervention activities was monitored for 12 months in the two active treatment groups. Self-reported weight was obtained at 6 and 12 months. RESULTS: More individuals assigned to mail treatment started it (88%) than did those assigned to phone treatment (69%). However, program completion rates were higher in the phone (36%) than mail (7%) intervention. The mean weight losses were 1.93, 2.38, and 1.47 kg at 6 months in the mail, phone, and usual care groups, respectively. The differences between the phone and usual care groups were statistically significant. The mean weight losses at 12 months did not differ by treatment group (2.28 kg mail, 2.29 kg phone, and 1.92 kg usual care). Greater weight loss was seen in men, older participants, and those with no prior experience in a weight-loss program. Heavier participants and those who reported current treatment for depression lost less weight. CONCLUSION: Although mail-and phone-based weight-loss programs can be delivered to large numbers of people in an MCO setting, additional work is needed to enhance their clinical efficacy as well as to assess their costs.

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Section: Introductionmentioning

confidence: 99%

Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes

et al. 2003

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“…A recent systematic review has looked at whether health professionals' management or organization of care for overweight and obese people could be improved. 6 Unfortunately the quality of the included studies was poor, thus making it dif®cult to make recommendations; however, use of reminders, intensive inpatient services and improved collaboration between services may prove to be useful.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional survey of the opinions on weight loss treatments of adult obese patients attending a dietetic clinic

Thompson

Thomas²

2000

Int J Obes

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OBJECTIVE: To investigate the views and opinions on weight loss treatments of adult obese patients attending a dietetic clinic. DESIGN: Cross-sectional survey. SUBJECTS: 161 adults attending dietetic outpatients clinics in Portsmouth for obesity with a body mass index of at least 30 kgam 2 . MEASUREMENTS: Self-administered questionnaire developed from a series of focus groups with obese adults. Key topics were previous attempts to lose weight, methods used, the role of physical activity and patients' views about treatment from health professionals. RESULTS: The preferences and usefulness of different methods to lose weight varied according to the number of attempts to lose weight, gender, age, body mass index and medical condition of the patient. Men were less likely to use special slimming products, attend slimming groups and swimming than women (odds ratios (95% con®dence interval), 0.1 (0.03 ± 0.6) for slimming groups other than Weight Watchers, 0.3 (0.1 ± 0.80) for special slimming products and 0.3 (0.1 ± 0.6) for swimming). Men were more likely to use physical activity (2.6 (1.1 ± 6.2)) and in particular walking (3.7 (1.0 ± 13.6)) and cycling (2.8 (1.0 ± 7.6)) and were more likely to see the dietitian (3.8 (1.4 ± 9.9)) than women. Those with more than 10 attempts to lose weight were more likely to see the dietitian (3.6(1.6 ± 8.2)), use Weight Watchers (2.5 (1.1 ± 5.6)) and newspapers and magazines (4.4 (1.8 ± 10.9)) than those with fewer attempts. The younger age group were more likely to use more vigorous forms of exercise (4.2 (1.6 ± 11.2) for keep ®t and 3.7 (1.5 ± 9.6) for cycling) than the older subjects. The most obese were more likely to have negative views on their treatment by health professionals (4.4 (1.9 ± 9.8)`chairs are never big enough' and 4.0 (1.8 ± 8.8)`I am regarded as a second class citizen') than those who were less obese. Those without a medical condition were more likely to exercise (2.8 (1.3 ± 6.3)) and use books (4.8 (2.0 ± 11.2)) than those with a medical condition. CONCLUSION: The views of obese people should be considered when planning services for the treatment of obesity and a variety of options should be available.

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“…2 From initial searches of electronic databases and requests for help, 7193 abstracts were screened (EH). Any studies that appeared potentially relevant (244) were independently assessed and cross-checked (EH and AMG).…”

Section: Resultsmentioning

confidence: 99%

“…General EPOC methods and methods speci®c to this review are published in full in the Cochrane Library. 1,2 The review process aimed to identify and study that had been undertaken to improve practice or the delivery of health care services for overweight and obese people, that is, that aimed to improve the management of obesity. The intention was to both describe the types of interventions that had been employed, as well as to evaluate their effectiveness in improving practice or patient outcomes.…”

Section: Methodsmentioning

confidence: 99%

A systematic review of interventions to improve health professionals’ management of obesity

et al. 1999

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OBJECTIVE: To determine the existence and effectiveness of interventions to improve health professionals' management of obesity or the organisation of care for overweight and obese people. DESIGN: A systematic review of intervention studies, undertaken according to standard methods developed by the Cochrane Effective Practice and Organisation of Care (EPOC) Group. 1 PARTICIPANTS: Trained health care professionals and overweight and obese patients. MEASUREMENTS: Objective measures of health professionals' practice and behaviours, and patient outcomes including satisfaction, behaviour, psychological factors, disease status, risk factors, and measures of body weight, fat, or BMI. RESULTS: Twelve studies that met all the review inclusion criteria were identi®ed. Three were randomised controlled trials of health professional-oriented interventions (such as the use of reminders and training) and one was a controlled before and after study to improve collaboration between a hospital clinic and GPs. A further eight randomised controlled trials were identi®ed of interventions comparing either the deliverer of weight loss interventions or the setting of the delivery of the intervention. The heterogeneity and generally limited quality of identi®ed studies make it dif®cult to provide recommendations for improving health professionals' obesity management. CONCLUSIONS: At present, decisions about improving the provision of services for overweight and obese people must be based on the evidence from patient interventions and good clinical judgement. Future research is required to identify cost-effective strategies for improving health professionals' management and the organisation of care for overweight and obese people.A full version of this review, including detailed descriptions of the included studies and data tables, is available in the Cochrane Library.2 The Cochrane Library is a database of systematic review and other evidence on the effects of health care, available on CD ROM from Update Software. For further information see: http:aawww.cochrane.co.uk.

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Improving health professionals' management and the organisation of care for overweight and obese people

Cited by 52 publications

References 123 publications

Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes

Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes

A cross-sectional survey of the opinions on weight loss treatments of adult obese patients attending a dietetic clinic

A systematic review of interventions to improve health professionals’ management of obesity

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