Ontology highlight
ABSTRACT: Background
There is a need for new strategies to improve the success of obesity treatment within the primary care setting.Objective
To determine if patients offered low out-of-pocket cost weight management tools achieved more weight loss compared to usual care.Design
Twelve-month pragmatic clinical weight loss trial with a registry-based comparator group performed in primary care clinics of an urban safety-net hospital.Participants
From a large clinical registry, we randomly selected 428 patients to have the opportunity to receive the intervention.Interventions
Medical weight management tools-partial meal replacements, recreation center vouchers, pharmacotherapy, commercial weight loss program vouchers, and a group behavioral weight loss program-for $5 or $10 monthly. Patients chose their tools, could switch tools, and could add a second tool at 6 months.Main measures
The primary outcome was the proportion of intervention-eligible patients who achieved ≥ 5% weight loss. The main secondary outcome was the proportion of on-treatment patients who achieved ≥ 5% weight loss.Key results
Overall, 71.3% (305 of 428) had available weight measurement data/PCP visit data to observe the primary outcome. At 12 months, 23.3% (71 of 305) of intervention-eligible participants and 15.7% (415 of 2640) of registry-based comparators had achieved 5% weight loss (p < 0.001). Of the on-treatment participants, 34.5% (39 of 113) achieved 5% weight loss. Mean percentage weight loss was - 3.15% ± 6.41% for on-treatment participants and - 0.30% ± 6.10% for comparators (p < 0.001). The initially preferred tools were meal replacements, pharmacotherapy, and recreation center passes.Conclusions
Access to a variety of low out-of-pocket cost weight management tools within primary care resulted in ≥ 5% body weight loss in approximately one quarter of low-income patients with obesity.Trial registration
https://clinicaltrials.gov/ct2/show/NCT01922934.
SUBMITTER: Saxon DR
PROVIDER: S-EPMC6848318 | biostudies-literature | 2019 Nov
REPOSITORIES: biostudies-literature
Saxon David R DR Chaussee Erin L EL Juarez-Colunga Elizabeth E Tsai Adam G AG Iwamoto Sean J SJ Speer Rebecca B RB Heyn Hilde H Kealey Elizabeth H EH Bessesen Daniel H DH
Journal of general internal medicine 20190826 11
<h4>Background</h4>There is a need for new strategies to improve the success of obesity treatment within the primary care setting.<h4>Objective</h4>To determine if patients offered low out-of-pocket cost weight management tools achieved more weight loss compared to usual care.<h4>Design</h4>Twelve-month pragmatic clinical weight loss trial with a registry-based comparator group performed in primary care clinics of an urban safety-net hospital.<h4>Participants</h4>From a large clinical registry, ...[more]