Bush J, Langley C, Mills S, Hindle L
Aston Pharmacy School, Aston University, Birmingham, UK.
Clin Obes. 2014 Apr;4(2):91-100. doi: 10.1111/cob.12049. Epub 2014 Mar 6.
This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m(-2)). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic.
本研究旨在评估一项通过英国某城市的全科医生诊所和社区药房开展的新型社区体重管理项目的有效性。本研究采用了一种非随机、回顾性的观察比较方法,对参与的全科医生诊所和社区药房收集的临床数据进行分析。研究对象为451名居住在社会经济高度贫困地区的超重或肥胖男性和女性(82%来自少数族裔,86%为女性,平均年龄:41.1岁,平均体重指数[BMI]:34.5kg/m²)。测量了基线、12周后和9个月后的体重、腰围和BMI。还分析了项目实施成本。在“我的选择体重管理项目”的前12周,64%的参与者体重减轻。但有相当数量的人退出。12周时平均体重减轻百分比(末次观察结转)为1.9%,最终随访(9个月)时为1.9%。在12周和最终随访时,在全科医生诊所参与项目的参与者和在药房参与项目的参与者之间,体重减轻没有显著差异。通过社区药房参与项目的每位参与者的成本更高,这是因为社区药房参与者的课程出勤率高于全科医生参与项目的参与者。“我的选择体重管理项目”在12周和9个月时使体重有适度减轻。此类项目可能不足以应对肥胖流行问题。