Primary studies included in this systematic review

loading
18 articles (18 References) Revert Studify

Primary study

Unclassified

Nutritional counselling in general practice: a cost effective analysis.

blocked
Authors Pritchard DA , Hyndman J , Taba F
Journal Journal of epidemiology and community health
Year 1999
Links Pubmed DOI PubMed Central

This article is included in 11 Systematic reviews Systematic reviews (11 references)

Loading references information
STUDY OBJECTIVE: To study the clinical and cost outcomes of providing nutritional counselling to patients with one or more of the following conditions: overweight, hypertension and type 2 diabetes. DESIGN: The study was designed as a random controlled trial. Consecutive patients were screened opportunistically for one or more of the above conditions and randomly allocated to one of two intervention groups (doctor/dietitian or dietitian) or a control group. Both intervention groups received six counselling sessions over 12 months from a dietitian. However, in the doctor/dietitian group it was the doctor and not the dietitian who invited the patient to join the study and the same doctor also reviewed progress at two of the six counselling sessions. SETTING: The study was conducted in a university group general practice set in a lower socioeconomic outer suburb of Perth, Western Australia. PATIENTS: Of the 273 patients randomly allocated to a study group, 198 were women. Age ranged from 25 to 65 years. Seventy eight per cent of patients resided in the lower two socioecnomic quartiles, 56 per cent described their occupation as home duties and 78 per cent were partnered. RESULTS: Both intervention groups reduced weight and blood pressure compared with the control group. Patients in the doctor/dietitian group were more likely to complete the 12 month programme than those in the dietitian group. Patients in the doctor/dietitian group lost an average of 6.7 kg at a cost of $A9.76 per kilogram, while the dietitian group lost 5.6 kg at a cost of $A7.30 per kilogram. CONCLUSION: General practitioners, in conjunction with a dietitian, can produce significant weight and blood pressure improvement by health promotion methods.

Primary study

Unclassified

Management of obesity in primary care.

blocked
Journal Obesity research
Year 1998
Links Pubmed DOI

This article is included in 2 Systematic reviews Systematic reviews (2 references)

Loading references information
Obesity is one of the most common presenting chronic medical conditions in primary care, yet it is not adequately treated. Physicians are often reluctant to counsel patients because of their limited training in treating chronic weight problems and negative attitudes toward obese patients. This study evaluated the feasibility of training physicians to provide weight control counseling to their patients. Eleven physicians were randomly assigned to either an obesity-counseling skills training group or to a control group. Physicians in the counseling skills group received training in behavioral and motivational weight control techniques using a five-step patient-centered model; they were also given patient materials for use in their practice. To evaluate pretraining to posttraining changes in physician counseling behavior, independent samples of patients with obesity were surveyed immediately after their visit to the physician's office. Physicians in both the counseling skills training and the control groups discussed weight with 42% to 47% of their patients at baseline. This increased to 89% in physicians who received training, whereas it remained at 42% in control physicians. Scores on a counseling measure also significantly increased from a mean of 2.7 to 9.9 in the counseling group, whereas scores in the control group remained low and stable (2.3 and 1.9, respectively). The training program was effective in improving the frequency and quality of counseling that physicians delivered to their patients with obesity. Future research is needed to evaluate the effect of physician counseling on the weight and physical activity level of their patients.

Primary study

Unclassified

Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome.

Journal Archives of general psychiatry
Year 1998
Links Pubmed DOI

This article is included in 4 Systematic reviews Systematic reviews (4 references)

Loading references information
BACKGROUND: This article presents results of the acute treatment phase of a 2-site study comparing cognitive behavioral group therapy (CBGT) and treatment with the monoamine oxidase inhibitor phenelzine sulfate for social phobia. METHODS: One hundred thirty-three patients from 2 sites received 12 weeks of CBGT, phenelzine therapy, pill placebo administration, or educational-supportive group therapy (an attention-placebo treatment of equal credibility to CBGT). The "allegiance effect," ie, the tendency for treatments to seem most efficacious in settings of similar theoretical orientation and less efficacious in theoretically divergent settings, was also examined by comparing responses to the treatment conditions at both sites: 1 known for pharmacological treatment of anxiety disorders and the other for cognitive behavioral treatment. RESULTs: After 12 weeks, phenelzine therapy and CBGT led to superior response rates and greater change on dimensional measures than did either control condition. However, response to phenelzine therapy was more evident after 6 weeks, and phenelzine therapy was also superior to CBGT after 12 weeks on some measures. There were few differences between sites, suggesting that these treatments can be efficacious at facilities with differing theoretical allegiances. CONCLUSIONS: After 12 weeks, both phenelzine therapy and CBGT were associated with marked positive response. Although phenelzine therapy was superior to CBGT on some measures, both were more efficacious than the control conditions. More extended cognitive behavioral treatment and the combination of modalities may enhance treatment effect.

Primary study

Unclassified

The relative effectiveness of two styles of educational package to change practice nurses' management of obesity.

Authors Ogden J , Hoppe R
Journal International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
Year 1997
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references)

Loading references information
OBJECTIVE: To examine the impact of two styles of educational package on practice nurses' management of obesity. SUBJECTS AND MEASURES: A questionnaire was completed by 66 practice nurses concerning their obesity related beliefs and the content and style of their weight related practices before and one month after being randomly allocated to either the 'learner centred' group (who received a leaflet and were invited to attend an interactive seminar), the 'expert group' (who received the leaflet) or the control group. At the one month follow up, practice nurses were also asked to give a brief questionnaire to five consecutive patients, who they saw for weight loss advice, concerning the content and style of the consultation. After 6 months, practice nurses, and patients were sent a questionnaire about their consultation style and weight loss, respectively. RESULTS: The packages had no differential effects on practice nurses' beliefs about obesity. However, practice nurses in the 'learner group' reported spending longer on their consultations and being more patient centred. Their patients rated themselves as more satisfied with the consultation and reported that they were offered calorie controlled diets less often. In contrast, practice nurses in the 'expert group' reported giving weight loss advice more frequently, being less patient centred and their patients reported greater confidence in, and likelihood of, weight loss and reported that they were more likely to be offered traditional weight loss interventions. The packages had no differential effects on patient weight. CONCLUSION: Practice nurses' and patients' beliefs and behaviour and the style of their interactions can be changed by both expert and learner centred educational packages. The style of packages should be chosen in terms of both the available resources and the desired outcomes.

Primary study

Unclassified

A shared care approach in obesity management: the general practitioner and a hospital based service.

Journal International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
Year 1996
Links Pubmed

This article is included in 2 Systematic reviews Systematic reviews (2 references)

Loading references information
OBJECTIVE: 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). DESIGN: A comparative study of two obesity management programmes. Patients were matched on gender, age and BMI (kg/m2). SUBJECTS: 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). MAIN OUTCOME MEASURES: 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. RESULTS: 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. CONCLUSION: 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.

Primary study

Unclassified

An evaluation of a television-delivered behavioral weight loss program: are the ratings acceptable?

Journal Journal of consulting and clinical psychology
Year 1996
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references)

Loading references information
This experiment evaluated the efficacy of television delivery of a behavioral weight reduction program. Seventy-one overweight adults were randomly assigned to a live-contact weight loss group that was videotaped for viewing by other groups, a live-contact group that was not videotaped, a television-delivered group that observed the videotaped weight loss sessions, or a waiting-list control group. Participants in all 3 treatment groups lost significantly more weight during the 8-week treatment program than those in the waiting-list control group. There was no significant weight loss differences among the 3 treatment groups during the program. These weight changes were maintained at 3-month follow-up. At 15-month follow-up, the television-delivered group and the live-contact group maintained their weight losses, whereas the videotaped group did not. Cost-effectiveness analyses indicated that the television-delivered group received the most cost-effective treatment.

Primary study

Unclassified

Weight reduction programmes at a rehabilitation centre and a health centre based on group counselling and individual support: short- and long-term follow-up study.

Authors Hakala P
Journal International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
Year 1994
Links Pubmed

This article is included in 3 Systematic reviews Systematic reviews (3 references)

Loading references information
The objective of this study was to evaluate the effects of two weight reduction programmes on moderately and severely obese subjects over a period of five years. The subjects were randomly divided into a rehabilitation centre group (RC group) and a health centre group (HC group). Treatment in the RC group consisted of a three-week in-patient weight reduction programme at a rehabilitation centre and in the HC group of a ten-week out-patient weight reduction course at a health centre. Treatment in both groups continued for up to 24 months with an individual follow-up at 1-2-month intervals by a general practitioner (GP) at the health centre. The subjects were 42 women and 10 men. The mean weight of women at the onset of the study was 104 kg and the mean BMI 39.5 kg/m2 and the respective means of men 121 kg and 40.1 kg/m2. The mean age of both sexes was 40 years. In the RC group the mean weight loss at 6, 12 and 24 months was 11.5, 9.1 and 5.9 kg in women, and 19.0, 18.3 and 11.2 kg in men, respectively. In the HC group the respective values were 5.5, 4.8 and 3.2 kg in women and 12.2, 6.7 and 2.8 kg in men. At the five-year follow-up the mean weight change from baseline was -6.8 kg in the men and $0.3 kg in the women of the RC group. In the HC group the mean weight returned to baseline level in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Primary study

Unclassified

Weight reduction in obese hypertensive patients.

blocked
Journal Family medicine
Year 1991
Links Pubmed

This article is included in 7 Systematic reviews Systematic reviews (7 references)

Loading references information
This study tested the feasibility of a low-technology office-based approach to weight reduction in obese hypertensive patients. Family practice residents were randomly assigned to either an experimental or a control group. Physicians in the experimental group were instructed in methods of weight reduction, which they then passed on to their patients. Patients of experimental physicians were seen monthly, their diets were discussed, and improvements were suggested. The control group patients received their usual care. After six months the experimental patients had lost significantly more weight than the controls and had significantly reduced the number of antihypertensive drugs while maintaining blood pressure control. After 12 months there was no significant difference between the two groups with respect to weight loss, blood pressure, or number of antihypertensive drugs. Experimental and control patients who lost weight had visited their physicians more frequently than those who did not and had reduced the number of antihypertensive medications they were taking. This educationally oriented intervention trial is an example of the type of research that is practical to perform in a family practice center and is applicable in family physicians' offices.

Primary study

Unclassified

Effects of peer support and therapist contact on long-term weight loss.

Journal Journal of consulting and clinical psychology
Year 1987
Links Pubmed DOI

This article is included in 3 Systematic reviews Systematic reviews (3 references)

Loading references information

Publication Thread

McDonald CJ et al [1992]

This thread includes 2 references