A computer support program that helps clinicians provide patients with metabolic syndrome tailored counseling to...

Physician counseling can help patients make substantial changes in diet and physical activity behaviors that can result in weight loss and a reduction in metabolic risk factors. Unfortunately, time constraints and a lack of training often make it difficult for physicians to provide effective counseling. The objective in this study was to test the effect of a computerized support tool to enhance brief physician-delivered health lifestyle counseling to patients with increased metabolic risk factors during two usual care visits.

This is a prospective controlled trial of a 12-month intervention conducted at two large community health centers serving mostly Hispanic patients. Participants (n = 279) had a body mass index (calculated as kg/m²) ≥ 25 and at least two components of the metabolic syndrome.

In the intervention group, a computer program was used to help patients set tailored self-management goals for weight loss, nutrition, and physical activity. Goals were then reviewed and reinforced at clinic visits with participants' physicians at baseline and again at 6 months. The control group received care as usual. Data were collected between July 2007 and August 2008.

Change in body weight was the primary outcome. Secondary measures included changes in blood glucose, blood cholesterol, blood pressure, physical activity, and energy intake.

Significantly more patients in the intervention group lost ≥ 5% of their body weight at 12 months than controls (26.3% vs 8.5%; odds ratio = 3.86; P < 0.01). Loss of > 5% of total body weight was associated with improvements in cardiovascular risk factors, including low-density lipoprotein cholesterol (-14.0 vs -4.1 mg/dL; P = 0.04).

A brief computer-based intervention designed to increase the dialogue between patients and clinicians about behavioral goals can lead to increased 12-month weight loss.