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BMC Public Health. 2019 Apr 2;19(1):365. doi: 10.1186/s12889-019-6679-3.

Randomised controlled trial and economic evaluation of a task-based weight management group programme.

Author information

1
Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research Unit, 2 Stayner's Road, London, E1 4AH, UK.
2
Pragmatic Clinical Trials Unit, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London, E1 2AT, UK.
3
Department of Health Sciences, The University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK.
4
Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London, E1 2AT, UK.
5
Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Health and Lifestyle Research Unit, 2 Stayner's Road, London, E1 4AH, UK. katie.smith@qmul.ac.uk.

Abstract

BACKGROUND:

Obesity is a rising global threat to health and a major contributor to health inequalities. Weight management programmes that are effective, economical and reach underprivileged groups are needed. We examined whether a multi-modal group intervention structured to cater for clients from disadvantaged communities (Weight Action Programme; WAP) has better one-year outcomes than a primary care standard weight management intervention delivered by practice nurses (PNI).

METHODS:

In this randomised controlled trial, 330 obese adults were recruited from general practices in London and allocated (2:1) to WAP (N = 221) delivered over eight weekly group sessions or PNI (N = 109) who received four sessions over eight weeks. Both interventions covered diet, physical activity and self-monitoring. The primary outcome was the change in weight from baseline at 12 months. To indicate value to the NHS, a cost effectiveness analysis estimated group differences in cost and Quality-Adjusted Life-Years (QALYs) related to WAP.

RESULTS:

Participants were recruited from September 2012 to January 2014 with follow-up completed in February 2015. Most participants were not in paid employment and 60% were from ethnic minorities. 88% of participants in each study arm provided at least one recorded outcome and were included in the primary analysis. Compared with the PNI, WAP was associated with greater weight loss overall (- 4·2 kg vs. - 2·3 kg; difference = - 1·9 kg, 95% CI: -3·7 to - 0·1; P = 0·04) and was more likely to generate a weight loss of at least 5% at 12 months (41% vs. 27%, OR = 14·61 95% CI: 2·32 to 91·96, P = 0·004). With an incremental cost-effectiveness ratio (ICER) of £7742/QALY, WAP would be considered highly cost effective compared to PNI.

CONCLUSIONS:

The task-based programme evaluated in this study can provide a template for an effective and economical approach to weight management that can reach clients from disadvantaged communities.

TRIAL REGISTRATION:

ISRCTN ISRCTN45820471 . Registered 12/10/2012 (retrospectively registered).

KEYWORDS:

Cost-effectiveness; Obesity; Weight loss; Weight management

PMID:
30940108
PMCID:
PMC6444848
DOI:
10.1186/s12889-019-6679-3
[Indexed for MEDLINE]
Free PMC Article

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