Metabolic syndrome and weight management programs in primary care: a comparison of three international healthcare systems

Sturgiss, Elizabeth; Madigan, Claire; Klein, Doug; Elmitt, Nicholas; Douglas, Kirsty

doi:10.1071/py18021

Cited by 5 publications

(3 citation statements)

References 18 publications

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“… 65 When developing weight management interventions, it is important to reflect on resource availability within primary care settings to ensure patients’ needs can be met within existing healthcare systems. 66 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

Madigan

Graham

Sturgiss

et al. 2022

BMJ

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Objective To examine the effectiveness of behavioural weight management interventions for adults with obesity delivered in primary care. Design Systematic review and meta-analysis of randomised controlled trials. Eligibility criteria for selection of studies Randomised controlled trials of behavioural weight management interventions for adults with a body mass index ≥25 delivered in primary care compared with no treatment, attention control, or minimal intervention and weight change at ≥12 months follow-up. Data sources Trials from a previous systematic review were extracted and the search completed using the Cochrane Central Register of Controlled Trials, Medline, PubMed, and PsychINFO from 1 January 2018 to 19 August 2021. Data extraction and synthesis Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Meta-analyses were conducted with random effects models, and a pooled mean difference for both weight (kg) and waist circumference (cm) were calculated. Main outcome measures Primary outcome was weight change from baseline to 12 months. Secondary outcome was weight change from baseline to ≥24 months. Change in waist circumference was assessed at 12 months. Results 34 trials were included: 14 were additional, from a previous review. 27 trials (n=8000) were included in the primary outcome of weight change at 12 month follow-up. The mean difference between the intervention and comparator groups at 12 months was −2.3 kg (95% confidence interval −3.0 to −1.6 kg, I 2 =88%, P<0.001), favouring the intervention group. At ≥24 months (13 trials, n=5011) the mean difference in weight change was −1.8 kg (−2.8 to −0.8 kg, I 2 =88%, P<0.001) favouring the intervention. The mean difference in waist circumference (18 trials, n=5288) was −2.5 cm (−3.2 to −1.8 cm, I 2 =69%, P<0.001) in favour of the intervention at 12 months. Conclusions Behavioural weight management interventions for adults with obesity delivered in primary care are effective for weight loss and could be offered to members of the public. Systematic review registration PROSPERO CRD42021275529.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

Madigan

Graham

Sturgiss

et al. 2022

BMJ

Self Cite

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“…8,11 These findings reinforce the likelihood that our data underestimate the true prevalence of metabolic syndrome in the primary care setting, particularly given that the prevalence of obesity has only increased since those studies were conducted, 36 and that the metabolic health of those seeking primary care are possibly worse than the population not seeking any medical care. 30,37 It is also unsurprising that those meeting the definition for metabolic syndrome had elevated clinical physical examination and laboratory measurements; however, these measurements were important when comparing the data from this group to the data of those without metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of identifying and describing the burden of early-onset metabolic syndrome in primary care electronic medical record data: a cross-sectional analysis

Boisvenue

Oliva

Manca

et al. 2020

cmajo

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M etabolic syndrome is a constellation of interconnected metabolic factors that contribute to the development of obesity, cardiovascular disease, type 2 diabetes and other related chronic conditions. 1-3 The main components of metabolic syndrome are widely considered to be elevated blood pressure (BP), low highdensity lipoprotein (HDL) cholesterol, hypertriglyceridemia, dysglycemia and excess visceral adiposity measured either by body mass index (BMI) or waist circumference. 4 The pathogenic mechanisms of metabolic syndrome are thought to be driven by the presence of chronic low-grade inflammation associated with the development of insulin resistance and excess adiposity. 5 The causes of metabolic syndrome are still under investigation and reviews have been published elsewhere. 4,6,7 Since metabolic syndrome is typically more prevalent in older populations, its characterization in younger adult populations is less studied. Existing reports are either based on

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“…Across Australia, primary health networks (PHNs) are Australian Government-funded organisations providing coordination and support to general practices and commissioning services based on local unmet needs. They are similar in function to other primary care commissioning bodies in the UK and Canada 17 and have key performance indicators that are set by the Australian Government. 18 Most PHNs employ staff to liaise between the PHN and general practices, and provide practices with individualised support and feedback.…”

Section: Introductionmentioning

confidence: 99%

Multifaceted intervention to increase the delivery of alcohol brief interventions in primary care: a mixed-methods process analysis

et al. 2023

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Background: Brief interventions (BIs) are effective for reducing harmful alcohol consumption, but their use in primary care is less frequent than clinically indicated. The REducing AlCohol-related Harm (REACH) Project aimed to increase the delivery of BIs in primary care. Aim: The aim of this paper is to assess the effectiveness of the REACH program in increasing alcohol BIs in general practice and explore the implementation factors that improve or reduce uptake by clinicians. Design and Setting: This paper reports on a sequential, explanatory mixed-methods study of the implementation of the REACH project in six general practice clinics serving low-income communities in Melbourne, Australia. Method: We conducted time-series analyses using routinely-collected patient records and semi-structured interviews, guided by the Consolidated Framework for Implementation Research. Results: The six intervention sites significantly increased their rate of recorded alcohol status (56.7% to 60.4%), whereas there was no significant change in the non-intervention practices (344 sites, 55.2% to 56.4%). Conclusion: REACH resources were seen as useful and acceptable by clinicians and staff. National policies that support the involvement of primary care in alcohol harm reduction helped promote ongoing intervention sustainability.

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Metabolic syndrome and weight management programs in primary care: a comparison of three international healthcare systems

Cited by 5 publications

References 18 publications

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials

Feasibility of identifying and describing the burden of early-onset metabolic syndrome in primary care electronic medical record data: a cross-sectional analysis

Multifaceted intervention to increase the delivery of alcohol brief interventions in primary care: a mixed-methods process analysis

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