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将数字支持工具Gro Health W8Buddy作为三级体重管理服务一部分的评估:观察性研究。

Evaluation of the Digital Support Tool Gro Health W8Buddy as Part of Tier 3 Weight Management Service: Observational Study.

作者信息

Hanson Petra, Abdelhameed Farah, Sahir Mohammed, Parsons Nick, Panesar Arjun, de la Fosse Michaela, Summers Charlotte, Kaura Amit, Randeva Harpal, Menon Vinod, Barber Thomas M

机构信息

Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.

Warwick Medical School, University of Warwick, Coventry, United Kingdom.

出版信息

J Med Internet Res. 2025 May 16;27:e62661. doi: 10.2196/62661.

Abstract

BACKGROUND

The escalating prevalence of obesity worldwide increases the risk of chronic diseases and diminishes life expectancy, with a growing economic burden necessitating urgent intervention. The existing tiered approach to weight management, particularly specialist tier 3 services, falls short of meeting the population's needs. The emergence of digital health tools, while promising, remains underexplored in specialized National Health Service weight management services (WMSs).

OBJECTIVE

This service evaluation study assessed the use, effectiveness, and clinical impact of the W8Buddy digital support tool as part of the National Health Service WMS.

METHODS

W8Buddy, a personalized digital platform, provides a tailored weight management plan to empower individuals and was collaboratively developed with input from patients, the clinical team, and DDM Health. It launched at the University Hospitals Coventry and Warwickshire tier 3 WMS in 2022. All patients accessing University Hospitals Coventry and Warwickshire WMS were offered W8Buddy as part of standard care. Data were analyzed using independent samples t tests and Fisher exact tests for continuous and categorical outcomes, respectively. Multiple linear regression analysis explored associations between participant weight, engagement with W8Buddy, and time in the service.

RESULTS

Complete datasets for weights were available for 421 patients (220 W8Buddy group and 192 nonuser control group). W8Buddy users, predominantly female (n=185, 84.1%) and Caucasian, had a mean age of 43 years, while nonusers averaged 46 years (P=.02). Starting weights were comparable: 134 kg in the W8Buddy group and 130.2 kg in controls (P=.14); however, W8Buddy users had slightly higher starting BMI (49.6 vs 46.8 kg/m, P=.08). A total of 33.5% (n=392) of patients activated W8Buddy and engaged with it. There was significant weight loss among W8Buddy users, with a 0.74 kg monthly loss compared to standard care (β=-.74, 95% CI -1.28 to -0.21; P=.007). The longer an individual stayed in this study and used W8Buddy, the more weight was lost. W8Buddy users with type 2 diabetes mellitus experienced a significant hemoglobin A reduction (59.8 to 51.2 mmol/mol, P=.02) compared to nonusers with type 2 diabetes. W8Buddy users also showed significant improvement across the Satisfaction With Life Scale, the Karolinska Sleepiness Scale, and quality of life visual analog scale (P<.001) during follow-up.

CONCLUSIONS

Participants engaging with W8Buddy as part of a digitally enabled tier 3 WMS demonstrated significant improvements in clinical and psychological outcomes, with weight changes statistically significant compared to those not engaging with the digital tool. Reduction in hemoglobin A was present in both groups; however, statistical significance was only reached among those engaging with W8Buddy. These findings suggest digital tools can augment traditional services and promote patient empowerment. Future studies must provide long-term data to understand if the benefits from the digital tool are sustained.

摘要

背景

全球肥胖患病率不断攀升,增加了慢性病风险,缩短了预期寿命,经济负担日益加重,亟需采取紧急干预措施。现有的分级体重管理方法,尤其是三级专科服务,无法满足人群需求。数字健康工具虽前景广阔,但在英国国家医疗服务体系(NHS)的专业体重管理服务(WMS)中仍未得到充分探索。

目的

本服务评估研究评估了W8Buddy数字支持工具作为NHS体重管理服务一部分的使用情况、有效性和临床影响。

方法

W8Buddy是一个个性化数字平台,提供量身定制的体重管理计划以帮助个人,并在患者、临床团队和DDM Health的参与下共同开发。它于2022年在考文垂大学医院和沃里克郡三级体重管理服务中心推出。所有使用考文垂大学医院和沃里克郡体重管理服务的患者都可获得W8Buddy作为标准护理的一部分。分别使用独立样本t检验和Fisher精确检验对连续和分类结果进行数据分析。多元线性回归分析探讨了参与者体重、与W8Buddy的互动以及在该服务中的时间之间的关联。

结果

421名患者(220名W8Buddy组和192名非用户对照组)有完整的体重数据集。W8Buddy用户以女性为主(n = 185,84.1%),为白种人,平均年龄43岁,而非用户平均年龄46岁(P = 0.02)。起始体重相当:W8Buddy组为134千克,对照组为130.2千克(P = 0.14);然而,W8Buddy用户的起始体重指数略高(49.6对46.8千克/米²,P = 0.08)。共有33.5%(n = 392)的患者激活并使用了W8Buddy。W8Buddy用户体重显著减轻,与标准护理相比,每月减轻0.74千克(β = -0.74,95%置信区间 -1.28至 -0.21;P = 0.007)。个体在本研究中使用W8Buddy的时间越长,体重减轻越多。与非2型糖尿病用户相比,2型糖尿病的W8Buddy用户糖化血红蛋白显著降低(从59.8降至51.2毫摩尔/摩尔,P = 0.02)。在随访期间,W8Buddy用户在生活满意度量表、卡罗林斯卡嗜睡量表和生活质量视觉模拟量表上也有显著改善(P < 0.001)。

结论

作为数字化三级体重管理服务一部分使用W8Buddy的参与者在临床和心理结果方面有显著改善,与未使用数字工具的参与者相比,体重变化具有统计学意义。两组糖化血红蛋白均有降低;然而,只有使用W8Buddy的参与者达到统计学显著性。这些发现表明数字工具可以增强传统服务并促进患者自主。未来研究必须提供长期数据以了解数字工具的益处是否能持续。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eaa/12125558/a8bcadfd57cd/jmir_v27i1e62661_fig1.jpg

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