West of Scotland Cancer Surveillance Unit, Public Health Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, Scotland, UK.
BMC Public Health. 2013 Mar 27;13:282. doi: 10.1186/1471-2458-13-282.
Community pharmacies may offer an accessible way of delivering weight-management programmes but there have been few trials that use clinically significant weight loss outcomes, objective measures of weight and follow-up to 12 months. We aimed to evaluate weight change among patients who used the Counterweight weight management programme delivered by community pharmacies.
The Counterweight Programme was introduced into community pharmacies in Fife, Scotland in 2009 for patients with a BMI ≥ 30 kg/m(2) or a BMI ≥ 2830 kg/m(2) with a co-morbidity in localities in which Counterweight was not available at GP practices. The aim was to achieve an energy deficit of 500-600 kcal per day. Counterweight specialist dietitians delivered training, support and patient information materials to community pharmacies. Patient weight was measured by pharmacy staff at each weight management session. Weight data recorded at each weight management session were used to estimate weight change and attendance at 3, 6 and 12 months.
Between March 2009 and July 2012, 458 patients were enrolled by the community pharmacies. Three-quarters of patients were women, mean age was 54 (SD 7.4) years and mean BMI 36.1 (SD 5.9) kg/m(2). Of 314 patients enrolled for at least 12 months, 32 (10.2% on an intention to treat basis) had achieved the target weight loss of ≥5%; this was 41.6% of those who attended at 12 months representing a mean weight loss of 4.1 kg. Using Last Observation Carried Forward, 15.9% achieved the target weight loss within 12 months of enrolling. There was no significant effect of sex, baseline BMI or age on weight loss.
The Counterweight pharmacy programme has a similar effectiveness to other primary care based weight management programmes and should be considered as part of a range of services available to a community to manage overweight and obesity.
社区药店可能提供一种易于获得的方式来实施体重管理计划,但很少有试验使用具有临床意义的体重减轻结果、客观的体重测量和随访至 12 个月。我们旨在评估使用社区药店提供的 Counterweight 体重管理计划的患者的体重变化。
2009 年,苏格兰法夫的社区药店引入了 Counterweight 计划,适用于 BMI≥30kg/m²或 BMI≥28kg/m²且伴有合并症的患者,在没有 Counterweight 的 GP 诊所提供服务的地区也适用。目标是每天达到 500-600 千卡的能量不足。Counterweight 专业营养师向社区药店提供培训、支持和患者信息材料。每次体重管理时,药店员工都会测量患者的体重。每次体重管理时记录的体重数据用于估计 3、6 和 12 个月时的体重变化和出勤率。
2009 年 3 月至 2012 年 7 月期间,458 名患者在社区药店登记参加。四分之三的患者为女性,平均年龄为 54 岁(标准差 7.4 岁),平均 BMI 为 36.1kg/m²(标准差 5.9kg/m²)。在至少登记 12 个月的 314 名患者中,有 32 名(基于意向治疗的 10.2%)达到了≥5%的目标体重减轻;这是在 12 个月时出席的患者的 41.6%,代表平均体重减轻 4.1kg。使用最后一次观察结转法,15.9%的患者在登记后 12 个月内达到了目标体重减轻。性别、基线 BMI 或年龄对体重减轻没有显著影响。
Counterweight 药店计划与其他基于初级保健的体重管理计划具有相似的效果,应被视为社区管理超重和肥胖的一系列服务的一部分。