Maston Gabrielle, Franklin Janet, Gibson Alice A, Manson Elisa, Hocking Samantha, Sainsbury Amanda, Markovic Tania P
Faculty of Medicine and Health, The University of Sydney, The Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, Camperdown, NSW 2050, Australia.
Metabolism & Obesity Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia.
Behav Sci (Basel). 2020 Sep 7;10(9):136. doi: 10.3390/bs10090136.
Meal replacement product-based diets are an effective weight loss intervention used in the management of obesity. Historically, these diets have been underutilised by HealthCare Professionals (HCPs). An online survey of mixed methods design was distributed to HCPs to capture current perceptions and prescribing patterns of meal replacement products (MRPs) in the management of overweight and obesity. A total of 303 HCPs working in weight management across Australia began the survey and 197 (65%) completed it. While over 70% of HCPs have prescribed MRP currently or in the past, MRPs are only prescribed to a median 7% of patients seeking weight management treatment. Qualitative analysis identified potential barriers to MRP prescription, which include experience with patient non-compliance, perceived poor long-term weight loss durability and safety concerns regarding the product and its use as a total meal replacement program. Safety concerns are centred on the perceived risk of weight cycling and its potential negative psychological impact. MRP prescription is 66% more likely to occur if HCPs had formal training in the use of MRPs relative to those who did not, with a relative risk (RR) of 1.7 (95% CI 1.4, 2.0). This study highlights the potential barriers to the prescription of MRPs, which are centred around safety concerns. This also indicates that formal training may enhance the likelihood of prescribing MRPs, suggesting that once HCPs have a comprehensive understanding of the products and the evidence behind their use, their prescription is likely to be increased.
基于代餐产品的饮食是用于肥胖管理的一种有效减肥干预措施。从历史上看，这些饮食一直未得到医疗保健专业人员（HCPs）的充分利用。一项采用混合方法设计的在线调查被分发给HCPs，以了解他们目前对代餐产品（MRPs）在超重和肥胖管理中的看法及处方模式。共有303名在澳大利亚从事体重管理工作的HCPs开始参与调查，其中197名（65%）完成了调查。虽然超过70%的HCPs目前或过去曾开具过MRP处方，但MRPs仅被开给了寻求体重管理治疗患者中的中位数7%。定性分析确定了MRP处方的潜在障碍，包括患者不依从的经历、认为长期减肥效果不佳以及对产品及其作为全代餐计划使用的安全性担忧。安全性担忧集中在体重波动的感知风险及其潜在的负面心理影响上。与未接受过MRPs使用方面正规培训的HCPs相比，接受过此类培训的HCPs开具MRP处方的可能性要高66%，相对风险（RR）为1.7（95%置信区间1.4，2.0）。本研究突出了MRP处方的潜在障碍，这些障碍主要围绕安全性担忧。这也表明正规培训可能会增加开具MRP处方的可能性，这意味着一旦HCPs对产品及其使用背后的证据有全面了解，他们开具处方的可能性可能会增加。
