BACKGROUND AND PURPOSE:

• Baer et al. (JAMA, 2020) investigated the effectiveness of combining online weight reduction programs plus population health management (nonclinical support staff) to help overweight and obese individuals lose weight

METHODS:

• Cluster randomized trial
• Participants
  • Patients with a scheduled primary care visit 
    • 20 to 70 years
    • BMI between 27 and <40
    • Diagnosis of hypertension or type 2 diabetes
• Interventions
  • Usual care
    • Patients mailed general information about weight management
  • Online program only
    • Videos on weight loss, sample meal plans, and tools for tracking weight, food intake, and physical activity
  • Combined program
    • Online program
    • Population health management: Support from nonclinical staff | Outreach in person, check-in calls and direct messaging
• Primary outcome
  • Weight change at 12 months based on measured weights recorded in the electronic health record
• Secondary outcome
  • Weight change at 18 months

RESULTS:

• 840 enrolled participants
  • Mean age: 59.3 years | 60% female | 76.8% white
• There was a significant difference in weight change at 12 months by group, with patients in the combined group having the greatest average weight loss (P<0.001)
  • Usual care: –1.2 kg (95% CI, –2.1 to –0.3 kg)
  • Online only: 1.9 kg (95% CI, –2.6 to –1.1 kg)
  • Combined: –3.1 kg (95% CI, –3.7 to –2.5 kg)
• There was a significant difference in the weight change between
  • The combined group and the usual care group
    • –1.9 kg (97.5% CI, –2.9 to –0.9 kg; P < 0.001)
  • The combined group and the online only group
    • -1.2 kg (95% CI –2.2 to –0.3 kg; P = 0.01)
• At 18 months the differences in weight loss between groups were maintained
  • Usual care: –1.9 kg (95% CI, –2.8 to –1.0 kg)
  • Online only: –1.1 kg (95% CI, –2.0 to –0.3 kg)
  • Combined: –2.8 kg (95% CI, –3.5 to –2.0 kg)

CONCLUSION:

• A combined program utilizing an online weight management program plus nonclinical staff support resulted in a small (approximately 3%) but significantly greater weight loss in patients with hypertension or diabetes
• The authors acknowledged that clinical outcomes may have been impacted because the primary care physicians were minimally involved

Learn More – Primary Sources:

Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial

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