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在初级保健中优先考虑体重管理的护理流程的实施和有效性:一个阶段式结集群随机试验
Leigh Perreault1,2,3, Qing Pan4, Carlos Rodriguez5
1Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Leigh.perreault@CUAnschutz.edu.
在初级保健中,PATHWEIGH干预有效地在18个月内将患者的平均体重减少了0.58公斤. 这种可扩展的肥胖治疗改善了大量成年人群的体重管理结果.
科学领域:
- 公共卫生 公共卫生
- 临床干预 临床干预
- 肥胖管理 肥胖管理
背景情况:
- 全人口肥胖需要可扩展的初级保健解决方案.
- 实用性试验对于实施有效的健康战略至关重要.
- 初级保健机构为肥胖干预提供了一个关键点.
研究的目的:
- 评估PATHWEIGH干预对人口体重的有效性.
- 在初级保健环境中评估体重减轻和维持18个月的体重.
- 确定系统级干预对肥胖治疗的影响.
主要方法:
- 一个阶梯集群随机化的实用试验,涉及56个初级保健诊所.
- 在PATHWEIGH干预集成领导力认可,EHR驱动的流程,和临床医生教育.
- 分析包括274,182名BMI≥25kg/m2的成年人在4年的时间里.
主要成果:
- 在18个月内,PATHWEIGH的平均体重减少了0.58公斤 (P < 0.001).
- 干预增加了接受体重相关护理的可能性 (OR=1.23,P < 0.001).
- 在接受护理的患者中观察到显著的体重减轻 (2.36公斤),其他患者的体重增加减轻 (0.32公斤).
结论:
- PATHWEIGH展示了一种务实的,可扩展的方法来管理初级保健中的肥胖症.
- 该干预措施对人口体重产生了积极的影响,并改善了与体重相关的护理服务.
- 初级保健中的系统层面的变化可以带来对肥胖的有意义的人口健康益处.
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