Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia.
Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Notting Hill, Australia.
Fam Pract. 2022 Jul 19;39(4):710-724. doi: 10.1093/fampra/cmab105.
Shared medical appointments (SMAs) may help mitigate some of the barriers for managing obesity in primary care. The primary aim of this systematic review was to measure the effect of weight loss SMAs.
Systematic searches using keywords and Medical Subject Headings for overweight, obesity, and SMAs were conducted in the CENTRAL, Medline Complete, PsycINFO, Scopus, CINAHL, EMBASE, and Web of Science databases with no date limits. Risk of bias was assessed using the Effective Health Practice Project Quality Assessment Tool for Quantitative Studies.
Fifteen studies involving weight loss SMAs in adults and children were identified. Six studies had controls. Inconsistency in reporting weight loss or weight change in controlled studies meant that data could not be pooled for meta-analysis. Results from individual studies indicated that SMAs can support adult patients to achieve significant weight loss. Women and older adults were more likely to take up SMA invitations. Results from the 5 studies involving children were less conclusive. Studies involving participants of a higher socioeconomic status tended to report lower attrition than studies involving participants who experienced disadvantage. These findings should be interpreted with caution as all but 1 included study was assessed as being weak in quality.
Overall, SMAs may be of benefit to address obesity in primary care, particularly for women and older adults. Appropriately designed prospective and controlled studies are required to engage their target audience and to assess whether SMAs are superior to other weight loss options in primary care.
共享医疗预约（SMAs）可能有助于缓解初级保健中肥胖管理的一些障碍。本系统评价的主要目的是衡量减肥 SMA 的效果。
使用超重、肥胖和 SMA 的关键词和医学主题词在 CENTRAL、Medline Complete、PsycINFO、Scopus、CINAHL、EMBASE 和 Web of Science 数据库中进行系统搜索，没有日期限制。使用有效健康实践项目质量评估工具对定量研究进行偏倚风险评估。
确定了 15 项涉及成人和儿童减肥 SMA 的研究。其中 6 项研究有对照组。由于对照研究报告减肥或体重变化的不一致性，因此无法进行荟萃分析以汇总数据。个别研究的结果表明，SMA 可以支持成年患者实现显著的体重减轻。女性和老年人更有可能接受 SMA 邀请。涉及儿童的 5 项研究的结果则不太确定。涉及社会经济地位较高的参与者的研究报告的脱落率低于涉及处于劣势的参与者的研究。由于除了 1 项研究外，所有研究的质量都被评估为较弱，因此应谨慎解释这些发现。
总体而言，SMA 可能有助于解决初级保健中的肥胖问题，特别是对女性和老年人。需要进行适当设计的前瞻性和对照研究，以吸引目标受众，并评估 SMA 是否优于初级保健中的其他减肥选择。
