Sherson Elaine A, Yakes Jimenez Elizabeth, Katalanos Nikki
Department of Family and Community Medicine and.
Department of Family and Community Medicine and Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM 87131, USA.
Fam Pract. 2014 Aug;31(4):389-98. doi: 10.1093/fampra/cmu020. Epub 2014 Jun 2.
The 5 A's (Assess, Advise, Agree, Assist and Arrange) is a model that can be used by primary care physicians and practitioners to promote patient behaviour change. The 5 A's model is a viable intervention for encouraging weight management in response to the epidemic of obesity among patients.
To identify and summarize quantitative research related to the 5 A's patients want to receive from their physicians during weight loss discussions and how frequently physicians use each practice.
We conducted a systematic literature review of the MEDLINE/PubMed database using relevant keywords. Of 230 articles originally identified, 15 articles included quantitative research data from cross-sectional studies related to the aim of this review.
Based on the available evidence, the majority of patients want to discuss weight loss with their physicians, with the Assist and Arrange aspects of the 5 A's being most desired. However, physicians most frequently Advise and Assess, and rarely Agree, Assist or Arrange.
There are some significant limitations to the available evidence, including a limited number of studies addressing patient preference, inconsistent assessment of all aspects of the 5 A's, a lack of longitudinal designs and failure to take contextual factors such as patient and physician characteristics into account when interpreting study results. Future studies should address these limitations, document the outcomes that result from better physician training in lifestyle modification strategies and determine how to best routinely implement all aspects of the 5 A's for weight management in family practice settings.
5A 模式（评估、建议、达成共识、协助和安排）是一种可供初级保健医生和从业者用于促进患者行为改变的模式。5A 模式是应对患者肥胖流行鼓励体重管理的一种可行干预措施。
识别并总结与患者在减肥讨论中希望从医生那里获得的 5A 相关的定量研究，以及医生使用每种做法的频率。
我们使用相关关键词对 MEDLINE/PubMed 数据库进行了系统的文献综述。在最初识别的 230 篇文章中，15 篇文章包含了与本综述目的相关的横断面研究的定量研究数据。
基于现有证据，大多数患者希望与医生讨论减肥问题，5A 模式中的协助和安排方面最受期望。然而，医生最常进行的是建议和评估，很少达成共识、协助或安排。
现有证据存在一些重大局限性，包括涉及患者偏好的研究数量有限、对 5A 模式所有方面的评估不一致、缺乏纵向设计，以及在解释研究结果时未考虑患者和医生特征等背景因素。未来的研究应解决这些局限性，记录更好的医生生活方式改变策略培训所产生的结果，并确定如何在家庭医疗环境中最佳地常规实施 5A 模式的所有方面以进行体重管理。
