Interventions to change the behaviour of health professionals and the organisation of care to
promote weight reduction in overweight and obese adults
Flodgren Gerd, Deane Katherine, Dickinson Heather O, Kirk Sara, Alberti Hugh, Beyer Fiona R, Brown James G, Penney Tarra L,
Summerbell Carolyn D, Eccles Martin P
Authors' objectives
Background: The prevalence of obesity is increasing globally and will, if left unchecked, have major implications for
both population health and costs to health services.Objectives: To assess the effectiveness of strategies to change the
behaviour of health professionals and the organisation of care to promote weight reduction in overweight and obese
people.Search methods: We updated the search for primary studies in the following databases, which were all
interrogated from the previous (version 2) search date to May 2009: The Cochrane Central Register of Controlled
Trials (which at this time incorporated all EPOC Specialised Register material) (The Cochrane Library 2009, Issue 1),
MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), and PsycINFO (Ovid). We identified further potentially
relevant studies from the reference lists of included studies.Selection criteria: Randomised controlled trials (RCTs) that
compared routine provision of care with interventions aimed either at changing the behaviour of healthcare
professionals or the organisation of care to promote weight reduction in overweight or obese adults.Data collection and
analysis: Two reviewers independently extracted data and assessed study quality.Main results: We included six RCTs,
involving more than 246 health professionals and 1324 overweight or obese patients. Four of the trials targeted
professionals and two targeted the organisation of care. Most of the studies had methodological or reporting
weaknesses indicating a risk of bias.Meta-analysis of three trials that evaluated educational interventions aimed at GPs
suggested that, compared to standard care, such interventions could reduce the average weight of patients after a year
(by 1.2 kg, 95% CI -0.4 to 2.8 kg); however, there was moderate unexplained heterogeneity between their results (I2 =
41%). One trial found that reminders could change doctors' practice, resulting in a significant reduction in weight
among men (by 11.2 kg, 95% CI 1.7 to 20.7 kg) but not among women (who reduced weight by 1.3 kg, 95% CI -4.1 to
6.7 kg). One trial found that patients may lose more weight after a year if the care was provided by a dietitian (by 5.6
kg, 95% CI 4.8 to 6.4 kg) or by a doctor-dietitian team (by 6 kg, 95% CI 5 to 7 kg), as compared with standard care.
One trial found no significant difference between standard care and either mail or phone interventions in reducing
patients' weight.Authors' conclusions: Most of the included trials had methodological or reporting weaknesses and
were heterogeneous in terms of participants, interventions, outcomes, and settings, so we cannot draw any firm
conclusions about the effectiveness of the interventions. All of the evaluated interventions would need further
investigation before it was possible to recommend them as effective strategies.
US:http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000984.pub2/abstract
Bibliographic details
Flodgren Gerd, Deane Katherine, Dickinson Heather O, Kirk Sara, Alberti Hugh, Beyer Fiona R, Brown James G,
Penney Tarra L, Summerbell Carolyn D, Eccles Martin P. Interventions to change the behaviour of health
professionals and the organisation of care to promote weight reduction in overweight and obese adults. Cochrane
Database of Systematic Reviews: Reviews 2010; Issue 3
AccessionNumber
10000000984
Date abstract record published
13/07/2012
Record Status
This is an abstract for a Cochrane review
Database of Abstracts of Reviews of Effects (DARE)
Produced by the Centre for Reviews and Dissemination
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