Multidisciplinary Teams and Obesity

Bernstein, Kevin; Manning, Debra; Julian, Regina

doi:10.1016/j.pop.2015.08.010

Cited by 16 publications

(5 citation statements)

References 23 publications

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“…Our review also shows that nurses are working within multidisciplinary teams to be effective in achieving positive weight outcomes (78% of multidisciplinary studies; 35% out of total studies). Despite the plethora of research that shows that a multidisciplinary approach is most effective in addressing obesity, many do not highlight the significant role nurses can play in achieving desirable weight outcomes and helping to relieve the burden of care in primary care settings brought upon by the high rate of obesity (Bernstein, Manning, & Julian, 2016; Frank, 1998). There is a great need to explore cost-effective models that would augment the role of nurses in providing care to obese and overweight patients.…”

Section: Discussionmentioning

confidence: 99%

Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review

et al. 2017

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The purpose of this systematic review was to determine whether nurse-delivered weight management interventions improve weight outcomes across the lifespan. We conducted a comprehensive search of the PubMed, CINAHL, and PsycINFO electronic databases. We graded the trials using an adapted Jadad approach for methodological quality. The search identified a total of 1,159 citations; 23 articles from 20 studies were eligible for this review. Sixty-five percent of the studies reported significant findings related to body mass index (BMI) or weight reduction. Studies that were particularly successful at helping participants reduce weight and/or BMI involved nurses engaged in health promotion activities, operating within multidisciplinary teams and/or providing consultations, physical activity education, and coaching over the phone. Of the studies that involved longer-term follow-up assessments, three out of nine studies showed a significant loss in weight or BMI between the intervention and control groups at follow-up times ranging from 12 months to 2 years.

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Section: Discussionmentioning

confidence: 99%

Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review

et al. 2017

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“…The syntax explored a broad range of terms used in definitions of PCMH, collaborative care, chronic care models, RCTs, and Quasi trials (full electronic search strings are listed in Table A1 ). We supplemented electronic searches by hand-searching bibliographies of several key systematic reviews [ 23 , 26 , 27 , 28 ] and retrieved studies to identify any relevant articles missed by the search strategy. Endnote (Version X9, Thompson Reuters, New York, NY, USA) software was used for reference management.…”

Section: Methodsmentioning

confidence: 99%

The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

John

Jani

Peters

et al. 2020

IJERPH

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Patient-centred care by a coordinated primary care team may be more effective than standard care in chronic disease management. We synthesised evidence to determine whether patient-centred medical home (PCMH)-based care models are more effective than standard general practitioner (GP) care in improving biomedical, hospital, and economic outcomes. MEDLINE, CINAHL, Embase, Cochrane Library, and Scopus were searched to identify randomised (RCTs) and non-randomised controlled trials that evaluated two or more principles of PCMH among primary care patients with chronic diseases. Study selection, data extraction, quality assessment using Joanna Briggs Institute (JBI) appraisal tools, and grading of evidence using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach were conducted independently. A quantitative synthesis, where possible, was pooled using random effects models and the effect size estimates of standardised mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals were reported. Of the 13,820 citations, we identified 78 eligible RCTs and 7 quasi trials which included 60,617 patients. The findings suggested that PCMH-based care was associated with significant improvements in depression episodes (SMD −0.24; 95% CI −0.35, −0.14; I2 = 76%) and increased odds of remission (OR 1.79; 95% CI 1.46, 2.21; I2 = 0%). There were significant improvements in the health-related quality of life (SMD 0.10; 95% CI 0.04, 0.15; I2 = 51%), self-management outcomes (SMD 0.24; 95% CI 0.03, 0.44; I2 = 83%), and hospital admissions (OR 0.83; 95% CI 0.70, 0.98; I2 = 0%). In terms of biomedical outcomes, with exception to total cholesterol, PCMH-based care led to significant improvements in blood pressure, glycated haemoglobin, and low-density lipoprotein cholesterol outcomes. The incremental cost of PCMH care was identified to be small and significantly higher than standard care (SMD 0.17; 95% CI 0.08, 0.26; I2 = 82%). The quality of individual studies ranged from “fair” to “good” by meeting at least 60% of items on the quality appraisal checklist. Additionally, moderate to high heterogeneity across studies in outcomes resulted in downgrading the included studies as moderate or low grade of evidence. PCMH-based care has been found to be superior to standard GP care in chronic disease management. Results of the review have important implications that may inform patient, practice, and policy-level changes.

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“…Many of the same team members are found in multidisciplinary obesity clinics and multidisciplinary diabetes clinics. Patients are at the center of both types of team, assisted by a primary physician, nurse and/or nurse practitioner, dietitian, exercise physiologist, and behaviorist ( 36 , 37 ). This core group may be complemented by a pharmacist (drug management currently plays a larger role in diabetes care than in obesity care), and perhaps a case manager.…”

Section: Diabetes and Obesity: Common Treatment Solutionsmentioning

confidence: 99%

Multidisciplinary Team–Based Obesity Treatment in Patients With Diabetes: Current Practices and the State of the Science

Foster

Sanchez-Collins²

2017

Diabetes Spectrum

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IN BRIEF Rates of obesity and diabetes are growing, as are their costs. Because the two diseases share many key determinants, the paradigms for their treatment overlap. For both, optimal treatment involves a multidisciplinary team following the Chronic Care Model of health care delivery. Combined treatment programs that include 1) a low-calorie diet individualized to patients’ preferences, 2) structured exercise that is also tailored to each patient, and 3) psychotherapy induce the largest weight changes in patients with diabetes. Although diet alone can achieve weight loss, exercise and cognitive behavioral therapy components can enhance the effects of dietary modification. A multidisciplinary team that includes a physician with expertise in pharmacotherapy, a nurse and/or nurse practitioner, a dietitian, an exercise physiologist, and a psychologist can provide a comprehensive weight loss program combining the most effective interventions from each discipline.

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Multidisciplinary Teams and Obesity

Cited by 16 publications

References 23 publications

Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review

Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review

The Effectiveness of Patient-Centred Medical Home-Based Models of Care versus Standard Primary Care in Chronic Disease Management: A Systematic Review and Meta-Analysis of Randomised and Non-Randomised Controlled Trials

Multidisciplinary Team–Based Obesity Treatment in Patients With Diabetes: Current Practices and the State of the Science

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