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在为期 24 个月的以初级保健为基础的远程健康生活方式教练计划中实现长期减肥:随机对照试验。

Long-term weight loss in a 24-month primary care-anchored telehealth lifestyle coaching program: Randomized controlled trial.

机构信息

Research Unit for General Practice, Department of Public Health, 6174University of Southern Denmark, Odense, Denmark.

User Perspectives and Community-based Interventions, Department of Public Health, 6174University of Southern Denmark, Odense, Denmark.

出版信息

J Telemed Telecare. 2022 Dec;28(10):764-770. doi: 10.1177/1357633X221123411.

Abstract

Long-term weight loss can reduce the risk of type 2 diabetes for people living with obesity and reduce complications for patients diagnosed with type 2 diabetes. We investigated whether a telehealth lifestyle-coaching program (Liva) leads to long-term (24 months) weight loss compared to usual care. In a randomized controlled trial,  = 340 participants living with obesity with or without type 2 diabetes were enrolled and randomized via an automated computer algorithm to an intervention group ( = 200) or to a control group ( = 140). The telehealth lifestyle-coaching program comprised of an initial one-hour face-to-face motivational interview followed by asynchronous telehealth coaching. The behavioural change techniques used were enabled by individual live monitoring. The primary outcome was a change in body weight from baseline to 24 months. Data were assessed for  = 136 participants (40%),  = 81 from the intervention group and  = 55 from the control group, who completed the 24-month follow-up. After 24 months mean body weight and body mass index were reduced significantly for completers in both groups, but almost twice as much was registered for those in the intervention group which was not significant between groups -4.4 (CI -6.1; -2.8) kg versus -2.5 (CI -3.9; -1.1) kg,  = 0.101. Haemoglobin A1c was significantly reduced in the intervention group -3.1 (CI -5.0; -1.2) mmol/mol, but not in the control group -0.2 (CI -2.4; -2.0) mmol/mol without a significant between group difference ( = 0.223). Low completion was partly due to coronavirus disease 2019. Telehealth lifestyle coaching improve long-term weight loss (> 24 months) for obese people with and without type 2 diabetes compared to usual care.

摘要

长期减肥可以降低肥胖人群患 2 型糖尿病的风险,并减少已确诊 2 型糖尿病患者的并发症。我们研究了远程医疗生活方式指导计划(Liva)是否与常规护理相比能实现长期(24 个月)体重减轻。在一项随机对照试验中,纳入了 340 名患有肥胖症且有或没有 2 型糖尿病的参与者,并通过自动计算机算法将他们随机分配到干预组(n=200)或对照组(n=140)。远程医疗生活方式指导计划包括一次初始的一小时面对面动机访谈,随后进行异步远程医疗指导。使用的行为改变技术是通过个体实时监测实现的。主要结局是从基线到 24 个月时的体重变化。对 136 名参与者(40%)的数据进行了评估,其中干预组有 81 名,对照组有 55 名完成了 24 个月的随访。24 个月后,两组的完成者体重和体重指数均显著降低,但干预组的降幅几乎是对照组的两倍,但组间差异无统计学意义-4.4(CI-6.1;-2.8)kg 与-2.5(CI-3.9;-1.1)kg, = 0.101。干预组的血红蛋白 A1c 显著降低-3.1(CI-5.0;-1.2)mmol/mol,但对照组没有降低-0.2(CI-2.4;-2.0)mmol/mol,组间差异无统计学意义( = 0.223)。低完成率部分归因于 2019 年冠状病毒病。与常规护理相比,远程医疗生活方式指导可改善肥胖人群(无论是否患有 2 型糖尿病)的长期体重减轻(>24 个月)。

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