体重減少管理のための適応行動介入:ランダム化臨床試験

Bonnie Spring¹, Angela F Pfammatter^1,2, Laura Scanlan¹

¹Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

JAMA

|May 14, 2024

まとめ

体重減少のための無線フィードバックシステム (WFS) は,コーチングを加えたWFSよりも優れませんでした. 肥満管理戦略を最適化するためにさらなる研究が必要である.

科学分野:

肥満に関する研究
デジタルヘルスの介入
行動医学

背景:

体重減少のためのライフスタイルの介入を臨床実践で実施することは困難です.
モバイルヘルス (mHealth) ソリューションは,追加されたサポートと無関係で,人口レベルの肥満管理に希望を示しています.

研究の目的:

ワイヤレスフィードバックシステム (WFS) のみによる減量効果と,電話によるコーチングによる減量効果を比較する.
最初の減量治療に反応しない被験者に対する様々なステップアップ介入の有効性を評価する.

主な方法:

400人の成人 (BMI 27~45) を対象とした非劣等性ランダム化試験では,WFSとWFSと3ヶ月のコーチングを比較した.
体重減少が最適でない参加者は,控えめか強烈なステップアップ介入に再ランダム化されました.
体重の変化は6,3,12ヶ月で評価され,不劣度差は-2. 5kgでした.

主要な成果:

WFSグループは,平均6ヶ月の体重減少を-2. 8kgを達成し,WFSプラスコーチンググループは,体重減少を-4. 8kg (差は-2. 0kg) にしました.
WFSはWFS+コーチングに劣らず,その差の90%CIには-2. 5kgの差が含まれていた.
反応しない患者に対するステップアップ介入は,体重減少において有意な違いをもたらさなかった.

結論:

ワイヤレスフィードバックシステムだけでは体重減少のための電話コーチングが付加された同じシステムに劣らないのです
効果的な減量管理戦略を特定し個々のニーズに応じた介入を個別化するために継続的な研究が不可欠です

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