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与人口健康管理集成的在线体重管理计划对体重变化的影响:随机临床试验
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
概括
在线体重控制计划与人口健康管理相结合,可显著增加初级保健患者的体重减轻. 这种干预比普通护理或单独的在线计划更有效.
科学领域:
- 医疗服务研究
- 肥胖药物
- 数字健康
背景情况:
- 在线减肥计划有潜力, 但在初级保健中未得到充分利用.
- 整合数字卫生工具与人口健康管理战略是慢性疾病管理的一个新兴领域.
研究的目的:
- 将联合干预 (在线计划+人口健康管理) 与单独在线计划和通常减肥护理的有效性进行比较.
- 评估增强支持对初级保健机构体重管理结果的影响.
主要方法:
- 一个集群随机试验,涉及840名年龄在20至70岁之间的超重/肥胖和高血压或2型糖尿病患者,来自美国15个初级保健机构.
- 干预组只接受在线体重管理计划或在线计划与人口健康管理相结合 (非临床人员支持和推广).
- 主要结局是12个月体重变化,次要结局是18个月.
主要成果:
- 组合干预组在12个月内实现了平均体重减轻3. 1公斤,明显高于仅在线计划组 (-1. 9公斤) 和常规护理组 (-1.2公斤).
- 综合治疗组与常规治疗组 (-1. 9公斤) 与仅在线治疗组 (-1. 2公斤) 的体重变化有统计学意义.
- 在18个月后,联合干预组继续显示较大体重减轻比其他组.
结论:
- 将人口健康管理与在线体重管理计划相结合,为初级保健患者减肥提供了统计学上显著的,尽管很小的好处.
- 这种方法可以改善超重或肥胖以及患有高血压或2型糖尿病等并发症的个体的体重管理策略.
- 需要进一步的研究来评估这些发现的概括性,可扩展性和长期耐用性.
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