Kempf Kerstin, Röhling Martin, Stichert Monika, Fischer Gabriele, Boschem Elke, Könner Jürgen, Martin Stephan
West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany.
Occupational Health Services, Kassenärztliche Vereinigung Nordrhein, Düsseldorf, Germany.
Int J Telemed Appl. 2018 Sep 9;2018:7530602. doi: 10.1155/2018/7530602. eCollection 2018.
Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight employees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical coaching lead to larger weight losses in overweight persons in an occupational health care setting.
Overweight employees (n=180) with a body mass index (BMI) of >27 kg/m were randomized into either a telemedical (TM) group (n=61), a telemedical coaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers automatically transferring the data into a personalized online portal, which could be monitored from participants and coaches. Participants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current data (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained in routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change was followed up after 12 months.
Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012) significantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared to the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group also reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and HbA1c.
Telemedical devices in combination with telemedical coaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study is registered with NCT01868763, ClinicalTrials.gov.
当提供持续的个人支持时,生活方式干预已被证明是有效的。然而,对于伴有个人指导的远程医疗方法是否有助于超重员工长期减重,目前尚缺乏相关认识。因此,我们检验了这样一个假设:在职业卫生保健环境中,基于远程医疗的生活方式干预并伴有远程医疗指导,会使超重者体重减轻更多。
体重指数(BMI)>27kg/m²的超重员工(n = 180)被随机分为远程医疗(TM)组(n = 61)、远程医疗指导(TMC)组(n = 58)或对照组(n = 61)。两个干预组都配备了体重秤和计步器,可自动将数据传输到个性化在线门户,参与者和指导者均可进行监测。TMC组的参与者每周还会收到心理指导者一次激励关怀电话,以讨论当前数据(当前体重和步数)以及实现诸如健康生活方式或减重等目标。对照组则接受常规护理。在12周干预后测定临床和人体测量数据。此外,在12个月后对体重变化进行随访。
TMC组(-3.1±4.8kg,p<0.0001)和TM组(-1.9±4.0kg;p = 0.0012)的参与者在1年随访期间体重显著减轻且保持稳定,而对照组体重无变化。与对照组相比,仅TMC组在12个月后体重减轻有显著差异(p<0.001)。TMC组和TM组的BMI、腰围和低密度脂蛋白胆固醇也有所降低。此外,TMC组的收缩压和舒张压、总胆固醇、高密度脂蛋白胆固醇和糖化血红蛋白水平也有所改善。
在职业卫生保健环境中,远程医疗设备与远程医疗指导相结合可使超重者长期显著减重。本研究已在ClinicalTrials.gov上注册,注册号为NCT01868763。