Richman R M, Webster P, Salgo A R, Mira M, Steinbeck K S, Caterson I D
Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.
Int J Obes Relat Metab Disord. 1996 May;20(5):413-9.
To describe the process of establishing a Shared Care obesity management programme between general practitioners and a hospital based specialist obesity service and to compare outcomes of the Shared Care programme (SC) to an established hospital based programme (MOS).
A comparative study of two obesity management programmes. Patients were matched on gender, age and BMI (kg/m2).
29 female and eight male (age: 47.0 +/- 2 years, BMI 35.9 +/- 0.8 kg/m2) patients enrolled in the Shared Care programme (SC) were matched to 81 female and 20 male (age: 45.8 +/- 1.1 years, BMI 35.7 +/- 0.4 kg/m2) patients enrolled in a hospital based programme (MOS).
Relative and absolute weight loss and retention rate were compared between the programmes at 10 and 26 weeks. Food habits were assessed at enrolment and week 10 of the programme in the SC group by a Food Habits Questionnaire and cognitive restraint, disinhibition and hunger were assessed by the Eating Inventory Questionnaire.
Shared Care patients (n = 28) lost significantly more weight than the MOS patients (n = 60) (SC 4.8 +/- 0.6 kg and MOS 2.6 +/- 0.4 kg; p = 0.0016) over the 10 weeks of the programme. At 26 weeks both groups demonstrated a 5 kg weight loss. There was a significant improvement in food habits, and cognitive restraint, disinhibition and hunger over the 10 weeks of the programme in the SC group. Patient satisfaction was reflected in a better retention rate at 26 weeks by the Shared Care group.
The study demonstrated that the obese patient managed in a shared care setting achieved better weight loss in the short term and attrition was lower in the longer term than a similar patient attending a specialist service based in a hospital.
描述在全科医生与医院专科肥胖症服务机构之间建立共享护理肥胖管理项目的过程，并将共享护理项目（SC）的结果与已建立的医院项目（MOS）进行比较。
对两个肥胖管理项目的比较研究。患者按性别、年龄和体重指数（kg/m²）进行匹配。
纳入共享护理项目（SC）的29名女性和8名男性患者（年龄：47.0±2岁，体重指数35.9±0.8 kg/m²）与纳入医院项目（MOS）的81名女性和20名男性患者（年龄：45.8±1.1岁，体重指数35.7±0.4 kg/m²）进行匹配。
在10周和26周时比较两个项目之间的相对和绝对体重减轻以及留存率。通过饮食习惯问卷在SC组项目入组时和第10周评估饮食习惯，并通过饮食量表问卷评估认知抑制、去抑制和饥饿感。
在项目的10周内，共享护理组患者（n = 28）比MOS组患者（n = 60）减重明显更多（SC组减重4.8±0.6 kg，MOS组减重2.6±0.4 kg；p = 0.0016）。在26周时，两组均减重5 kg。在项目的10周内，SC组的饮食习惯、认知抑制、去抑制和饥饿感有显著改善。共享护理组在26周时更高的留存率反映了患者满意度。
该研究表明，与在医院专科服务机构就诊的类似患者相比，在共享护理环境中管理的肥胖患者在短期内减重效果更好，长期内损耗更低。
