Avedis Donabedian Research Institute (FAD), Provença, 293, pral., Barcelona 08037, Spain; Universitat Autònoma de Barcelona, Plaça Cívica, Bellaterra, Barcelona 08103, Spain.
Avedis Donabedian Research Institute (FAD), Provença, 293, pral., Barcelona 08037, Spain; Universitat Autònoma de Barcelona, Plaça Cívica, Bellaterra, Barcelona 08103, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain; Institute of General Practice, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main D-60590, Germany.
Patient Educ Couns. 2023 May;110:107647. doi: 10.1016/j.pec.2023.107647. Epub 2023 Jan 24.
To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity.
Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-management", "adult" and "obesity" for content. Two independent reviewers assessed eligible references; one reviewer extracted data, a second checked accuracy.
We identified 497 RCTs (58% US, 20% Europe) including 99,741 (median 112, range 11-5145) adults living with overweight/obesity. Most research evaluated clinical outcomes (617, 55%) and behaviors adherence (255, 23%). Empowerment skills, quality of life and satisfaction were less targeted (8%, 7%, 0.2%, respectively). The most frequent techniques included sharing information (858, 99%), goal setting (619, 72%) and self-monitoring training (614, 71%), provided face-to-face (386, 45%) or in combination with remote techniques (256, 30%). Emotional management, social support and shared-decision were less frequent (18%, 26%, 4%). Socio-economic status, minorities or health literacy were seldom reported.
There is a need of widening the scope of research by focusing on outcomes important to patients, assessing emotional/social/share-decision support, exploring remote techniques and including vulnerable populations.
对针对超重/肥胖成年人的自我管理干预措施和与患者相关的结果进行证据图谱绘制。
我们遵循阿特金和奥马利的方法,在五个电子数据库中搜索了针对超重/肥胖的自我管理干预措施的随机对照试验(RCT)。我们使用了“自我管理”、“成人”和“肥胖”这三个术语作为关键词。两位独立的审稿人评估了合格的参考文献;一位审稿人提取数据,另一位审稿人检查准确性。
我们确定了 497 项 RCT(58%来自美国,20%来自欧洲),包括 99741 名(中位数为 112,范围为 11-5145)患有超重/肥胖的成年人。大多数研究评估了临床结果(617 项,55%)和行为依从性(255 项,23%)。赋能技能、生活质量和满意度的研究目标较少(分别为 8%、7%和 0.2%)。最常见的技术包括信息共享(858 项,99%)、目标设定(619 项,72%)和自我监测培训(614 项,71%),这些技术主要通过面对面(386 项,45%)或与远程技术相结合(256 项,30%)提供。情绪管理、社会支持和共同决策的研究较少(18%、26%和 4%)。社会经济地位、少数族裔或健康素养很少被报告。
需要扩大研究范围,关注对患者重要的结果,评估情绪/社会/共同决策支持,探索远程技术,并纳入弱势群体。