Conroy Molly B, Bryce Cindy L, McTigue Kathleen M, Tudorascu Dana, Gibbs Bethany Barone, Comer Diane, Hess Rachel, Huber Kimberly, Simkin-Silverman Laurey R, Fischer Gary S
University of Pittsburgh, Pittsburgh, PA 15213, United States.
University of Pittsburgh, Pittsburgh, PA 15213, United States.
Contemp Clin Trials. 2017 Mar;54:60-67. doi: 10.1016/j.cct.2017.01.001. Epub 2017 Jan 12.
Maintaining weight loss is a significant challenge in combating obesity. The goal of Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) is to evaluate the use of tools delivered through an electronic health record (EHR) and patient portal, with or without health coach support, to help primary care patients maintain weight loss. EHR tools include flowsheets, standardized surveys, and secure patient messaging. Inclusion criteria were age 18-75years, voluntary 5% weight loss in the past 2years with prior BMI≥25kg/m, and no bariatric procedures in past 5years. Participants were randomized 1:1 to tailored online coaching with EHR tracking tools (CC) or EHR tracking tools alone (TO). We screened 721 individuals between October 2013 and February 2015; 194 participants enrolled (98 CC; 96 TO). The most common reasons for not enrolling included lack of interest (56%), not meeting age or weight loss criteria (17%), and no verified prior weight loss (10%). At baseline, participants were 53.4 (SD 12.2) years old, 74% female, and 88% White; 95% reported moderate physical activity. Average weight and BMI at baseline were 189.1 (SD 42.1) lbs and 30.4 (5.9) kg/m, respectively. Pre-weight loss BMI was 34.4 (SD 6.5) kg/m. Participants lost an average of 11.3% (SD 6.6) of their body weight before enrolling. Demographic and clinical characteristics did not differ by randomized group. The study successfully identified and recruited primary care patients with recent voluntary weight loss for participation in a weight maintenance program that uses EHR-based tools.
维持体重减轻是对抗肥胖的一项重大挑战。通过初级保健中的技术辅助创新维持活动与营养（MAINTAIN-pc）的目标是评估通过电子健康记录（EHR）和患者门户网站提供的工具（无论有无健康教练支持）对帮助初级保健患者维持体重减轻的作用。电子健康记录工具包括流程图、标准化调查和安全的患者信息传递。纳入标准为年龄18至75岁、过去2年中自愿减重5%且之前BMI≥25kg/m²、过去5年内未接受过减肥手术。参与者按1:1随机分为接受量身定制的在线指导并使用电子健康记录跟踪工具的组（CC组）或仅使用电子健康记录跟踪工具的组（TO组）。我们在2013年10月至2015年2月期间筛选了721人；194名参与者入组（98名CC组；96名TO组）。未入组的最常见原因包括缺乏兴趣（56%）、未达到年龄或体重减轻标准（17%）以及无经核实的既往体重减轻情况（10%）。在基线时，参与者年龄为53.4（标准差12.2）岁，74%为女性，88%为白人；95%报告有中等强度的身体活动。基线时的平均体重和BMI分别为189.1（标准差42.1）磅和30.4（5.9）kg/m²。减重前的BMI为34.4（标准差6.5）kg/m²。参与者在入组前平均减重11.3%（标准差6.6）。人口统计学和临床特征在随机分组中无差异。该研究成功识别并招募了近期自愿减重的初级保健患者参与一项使用基于电子健康记录工具的体重维持计划。
