A randomized clinical trial of the effectiveness of a Web‐based health behaviour change support system and group lifestyle counselling on body weight loss in overweight and obese subjects: 2‐year outcomes

Teeriniemi, Anna-Maria; Salonurmi, Tuire; Jokelainen, Terhi; Vähänikkilä, Hannu; Alahäivälä, Tuomas; Karppinen, Pasi; Enwald, Heidi; Huotari, Maija‐Leena; Laitinen, Jaana; Oinas-Kukkonen, Harri; Savolainen, Markku J.

doi:10.1111/joim.12802

Cited by 51 publications

(45 citation statements)

References 35 publications

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“…For these patients, we believe the next level of care should be a multidisciplinary approach including services such as a refocused course of physical therapy with a subspecialist, acupuncture, myofascial massage, nutrition optimization, smoking cessation counseling, and/or cognitive behavioral therapy. All these services have a growing body of evidence to support their efficacy in addressing contributors of musculoskeletal pain . Our study results also support that patient complexity is influenced not only by clinical diagnosis but also by symptom burden and response to treatment, and equitable reimbursement based on patient complexity is essential so that providers can dedicate the time‐intensive expertise these patients require and deserve.…”

Section: Discussionsupporting

confidence: 70%

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

Cheng

Calfee

Colditz

et al. 2019

PM&R

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Background: Physiatrists' unique training in person-centered biopsychosocial management of complex problems may influence musculoskeletal patients' expectations and self-and/or physician-referral patterns to physiatrists. Consequently, average patient complexity and need for multi-disciplinary services may be increased in physiatric patients. Objective: To compare musculoskeletal patients' self-reported physical and emotional health according to provider specialty. Researchers tested the null hypothesis that there is no significant difference in Patient-Reported Outcomes Measurement Information System (PROMIS) scores between patients who present to physiatrists in comparison to other musculoskeletal specialists. Design: Cross-sectional study. Setting: Orthopedic department of a tertiary academic medical center. Patients: Participants included 31 791 new adult patients (mean age 52.6 AE 16.2 years) who presented for initial elective evaluation of a musculoskeletal problem by an orthopedic surgeon or sports medicine trained emergency medicine, family medicine, pediatric, or physiatric physician. Methods: Patients completed the PROMIS computer adaptive test (CAT) Physical Function, Pain Interference, Anxiety, and Depression domains at department check-in prior to the physician encounter. Score differences by provider type were assessed using Wilcoxon rank-sum tests. Main Outcome Measurements: Mean PROMIS score in each domain subdivided by physiatric, surgical, and other nonsurgical provider type. Results: In total, 2081 patients presented to physiatrists, 28 267 presented to surgeons, and 1443 presented to other nonsurgical providers. For each respective provider type, average PROMIS scores were Physical Function 38.9 AE 8.2, 41.5 AE 9.5, and 43.5 AE 8.2; Pain Interference 62.6 AE 7.2, 60.9 AE 7.7, and 59.2 AE 6.8; Anxiety 54.5 AE 10. 4, 51.9 AE 10.6, and 49.8 AE 9.8; and Depression 49.3 AE 10.4, 47.0 AE 10.0, and 44.2 AE 8.7. Physiatric patients had significantly worse average scores for all domains compared to surgical (P < .001) and other nonsurgical patients (P < .001). Conclusions: Average PROMIS Physical Function, Pain Interference, Anxiety, and Depression scores were worse in musculoskeletal patients who presented to physiatrists in comparison to surgical or other nonsurgical providers. This suggests that some patients who choose to see or are referred to see physiatrists may have more or be more willing to endorse having biopsychosocial impairments.

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Section: Discussionsupporting

confidence: 70%

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

Cheng

Calfee

Colditz

et al. 2019

PM&R

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“…In our PrevMetSyn (Prevention of Metabolic Syndrome) trial, the best weight loss results were obtained with the combination of CBT group counselling and ICT method, both with a specific emphasis on eating behaviour [19]. The present study investigates the results further by evaluating whether ICT counselling focussing on lifestyle changes can lower the prevalence of MetS.…”

Section: Introductionmentioning

confidence: 92%

Lifestyle counselling by persuasive information and communications technology reduces prevalence of metabolic syndrome in a dose–response manner: a randomized clinical trial (PrevMetSyn)

et al. 2020

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“…99 A RCT showed the effectiveness of a Web-based health behaviour change support system and group lifestyle counselling on body weight loss in overweight and obese subjects. 100 A systematic review on internet-delivered interventions in patients with CAD has shown that personalised, concrete support for behaviour change may have favourable outcomes; however, a considerable heterogeneity between studies with respect to the design and quality hinder sound conclusions. 101 Adherence Cardiovascular fixed-dose combination pills, or polypills, may help address the widespread lack of access and adherence to proved medicines.…”

Section: Behaviourmentioning

confidence: 99%

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

Piepoli

Abreu

Albus

et al. 2019

Eur J Prev Cardiolog

181

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European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.

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A randomized clinical trial of the effectiveness of a Web‐based health behaviour change support system and group lifestyle counselling on body weight loss in overweight and obese subjects: 2‐year outcomes

Abstract: The combination of CBT-based group counselling and HBCSS-based weight management is feasible for overweight or obese individuals. Moreover, HBCSS alone could be disseminated to the population at large as an effective means of treating obesity.

Cited by 51 publications

References 35 publications

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

PROMIS Physical and Emotional Health Scores Are Worse in Musculoskeletal Patients Presenting to Physiatrists than to Other Orthopedic Specialists

Lifestyle counselling by persuasive information and communications technology reduces prevalence of metabolic syndrome in a dose–response manner: a randomized clinical trial (PrevMetSyn)

Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology

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