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人口健康管理と統合されたオンライン体重管理プログラムの体重変化への影響:ランダム化臨床試験
Heather J Baer1,2,3, Ronen Rozenblum1,2, Barbara A De La Cruz1
1Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA
|November 3, 2020
まとめ
オンラインの体重管理プログラムと集団の健康管理を組み合わせると,プライマリケア患者の体重減少が著しく増加しました. この介入は通常のケアや オンラインプログラムより効果的であることが判明しました
科学分野:
- 医療サービス研究
- 肥満 医学
- デジタル・ヘルス
背景:
- オンラインでの体重管理プログラムは 潜在的可能性を示していますが プライマリケアでは十分に活用されていません
- デジタルヘルスのツールを 人口の健康管理戦略に統合することは 慢性疾患管理の新興分野です
研究 の 目的:
- 体重減少のためのオンラインプログラムと通常のケアとの組み合わせによる介入 (オンラインプログラム+人口健康管理) の有効性を比較する.
- 体重管理への支援の効果を評価する.
主な方法:
- 体重過多/肥満,高血圧,または2型糖尿病を患っている20〜70歳の参加者840人を対象としたクラスターランダム化試験です.
- 介入グループは,オンラインでの体重管理プログラムのみ,またはオンラインでの人口健康管理 (非臨床スタッフのサポートとアウトリーチ) と組み合わせたプログラムを受け取った.
- 主要評価は12ヶ月後の体重変化で,次要評価は18ヶ月後の体重変化でした.
主要な成果:
- オンラインプログラムのみのグループ (-1. 9 kg) と通常のケア (-1. 2 kg) よりも,平均体重減少が12ヶ月で達成されました.
- 体重の変化の違いは,通常のケアを受けたグループ (-1. 9kg) とオンラインプログラムのみを受けたグループ (-1. 2kg) の間で統計的に有意であった.
- 18ヶ月後も,他のグループと比較して,統合された介入グループは,より大きな体重減少を示し続けました.
結論:
- 集団の健康管理とオンラインの体重管理プログラムを組み合わせると,小規模な医療従事者の体重減少に統計的に有意な利点があります.
- このアプローチは,過体重や肥満,高血圧や2型糖尿病などの併存疾患を有する個人の体重管理戦略を向上させる可能性があります.
- これらの発見の汎用性,スケーラビリティ,長期的な耐久性を評価するためにさらなる研究が必要である.
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