AM, MPH, PhD, FASLM, Board Member, Australasian Society of Lifestyle Medicine (ASLM), Vic; Director, Centre for Health Promotion and Research, NSW; Adjunct Professor, Southern Cross University, NSW.@
PhD, RN, Adjunct Associate Professor, School of Health Sciences, Southern Cross University, NSW; Board Member, Australasian Society of Lifestyle Medicine (ASLM), Vic; Director, Lifestyle Medicine Programs, NSW @.
Aust J Gen Pract. 2019 Oct;48(10):681-688. doi: 10.31128/AJGP-05-19-4940.
Programmed shared medical appointments (pSMAs) are an extension of shared medical appointments (SMAs) for managing chronic diseases. Acceptance and outcomes of a trial for weight management are reported here.
Six programmed sessions in weight management were carried out in seven NSW primary healthcare centres.
Seventy-seven per cent of 216 participants (64 male, 102 female) completed at least four of six pSMAs over 16-18 weeks ('adherers'). Eighty-five per cent of adherers approved of pSMAs, and 73% said they would prefer these over a standard clinical consult. Providers also rated the process highly. Overall mean weight loss over 12 months was 3.2% (95% confidence interval [CI]: 2.2, 4.3; P <0.001). For adherers, mean weight loss was 4.3% for males (95% CI: 2.6, 6.1; P <0.001) and 4.2% for females (95% CI: 2.7, 5.7; P <0.001), with 46% of males and 35% of females maintaining clinically significant losses (>5%) after 12 months. pSMAs were calculated to be four times more cost effective and up to seven times more time effective than 1:1 consultations for weight loss.
pSMAs are a popular, cost and time-effective adjunct to standard clinical management.
程序化共享医疗预约（pSMAs）是管理慢性病的共享医疗预约（SMAs）的延伸。本文报告了一项用于体重管理的试验的接受度和结果。
在新南威尔士州的七家初级保健中心进行了六次程序化体重管理课程。
在 16-18 周的时间内，216 名参与者中有 77%（64 名男性，102 名女性）完成了至少四次 pSMAs（“参与者”）。85%的参与者认可 pSMAs，73%的参与者表示他们更愿意选择 pSMAs 而不是标准临床咨询。提供者也对该过程给予了高度评价。12 个月的总体平均体重减轻为 3.2%（95%置信区间[CI]：2.2，4.3；P <0.001）。对于参与者，男性的平均体重减轻为 4.3%（95%CI：2.6，6.1；P <0.001），女性为 4.2%（95%CI：2.7，5.7；P <0.001），46%的男性和 35%的女性在 12 个月后维持了有临床意义的体重减轻（>5%）。pSMAs 被计算为比 1:1 咨询减肥更具成本效益，效率提高了 4 倍，时间效率提高了 7 倍。
pSMAs 是标准临床管理的一种受欢迎、成本效益高且省时的辅助手段。
