Effectiveness of a motivational intervention on overweight/obese patients in the primary healthcare: a cluster randomized trial

Abstract

BackgroundOverweight and obesity are common health problems which increase the risk of developing several serious health conditions. The main difficulty in the management of weight-loss lies in its maintenance, once it is achieved. The aim of this study was to investigate whether a motivational intervention, together with current clinical practice, was more efficient than a traditional intervention, in the treatment of overweight and obesity and whether this intervention reduces cardiovascular risk factors associated with overweight and obesity.MethodsMulti-centre cluster randomized trial with a 24-month follow-up included 864 overweight/obese patients randomly assigned. Motivational intervention group (400 patients), delivered by a nurse trained by an expert psychologist, in 32 sessions, 1 to 12 fortnightly, and 13 to 32, monthly, on top of their standard programmed diet and exercise. The control group (446 patients), received the usual follow-up.ResultsWeight reduction was statistically significant in the second year with a mean reduction of 1.0 Kg in the control group and 2.5 Kg in the intervention group (p = 0. 02). While 18.1% of patients in the control group reduced their weight by more than 5%, this percentage rose to 26.9% in the intervention group, which is statistically significant (p = 0.04). Patients in the motivational intervention group had significantly greater improvements in triglycerides and APOB/APOA1ratio.ConclusionsThe results highlight the importance of the group motivational interview in the treatment of overweight /obese patients in primary care, and in the improvement of their associated cardiovascular risks factors.Trial registration ClinicalTrials.gov Identifier: NCT01006213 October 30, 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0644-y) contains supplementary material, which is available to authorized users.

<p>Effectiveness of a Patient-Centered Weight Management Model in a Community Pharmacy: An Interventional Study</p>

“…27 In another study in primary care setting where the intervention was limited to a motivational intervention, a 5% reduction in weight was achieved by 22.6% of patients at 12 months of follow-up (no statistically significant differences with the control group) and nearly 50% of patients were lost to follow-up. 21 A possible explanation for these differences with previous studies carried out in community pharmacies or in Spanish primary care centers could be that we had no losses to follow-up while in these previous studies the average participant dropout rate ranged from 8.3% to 79%. The high retention of patients in our study could be due to this ongoing follow-up taking place when patients on regular prescription medicines collected them in the community pharmacy.…”

“…27 In another study in primary care setting where the intervention was limited to a motivational intervention, a 5% reduction in weight was achieved by 22.6% of patients at 12 months of follow-up (no statistically significant differences with the control group) and nearly 50% of patients were lost to follow-up. 21 …”

“…Patients in the interventional group showed statistically significant weight reduction and improvements in biochemical markers. 21 In light of this, the evaluation of an intervention in weight management together with an optimization of the medication in community pharmacies needed to be developed. The results of such a study will demonstrate the role of the community pharmacy as a valuable actor in chronic disease control within the health system.…”

“…Patients in the interventional group showed statistically significant weight reduction and improvements in biochemical markers. 21 …”

Primary Care Nurses' Perceptions and Experiences of Patients Being Overweight, as well as Visions and Attitudes About Working with Lifestyle Issues: A Qualitative Interview Study

“…The main di culty in the management of weight loss lies in its maintenance once it is achieved. One study showed that signi cantly more patients in a motivational group treatment achieved a reduction of 5% or more of the initial weight and improved cardiovascular risk factors compared to the control group [24].…”