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Khazaei R, Maleklou F, Bodaghabadi Z, Tavana MM, Kluzek S, Sharafi SE, Feshki MS, Alizadeh Z. Developing an 8-Week, Tele-Education Weight Control and Exercise Programme, and Evaluating Its Effects on Weight and Pain Reduction in Patients With Obesity and Knee Osteoarthritis: A Double-Blinded Randomised Clinical Trial. Musculoskeletal Care 2024; 22:e1926. [PMID: 39123329 DOI: 10.1002/msc.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a leading cause of disability among the elderly and is often exacerbated by obesity. Research supports weight loss and exercise therapy as key strategies for managing knee OA-related disability. Concurrently, telemedicine is becoming a popular healthcare approach. This study aimed to develop and evaluate an 8-week tele-education programme's impact on weight control and knee OA outcomes. METHODS/DESIGN Participants with knee OA and obesity were included. Baseline data on pain (VAS index), physical activity (GPAQ questionnaire), and quality of life (EQ5D and KOOS questionnaires) were collected. Performance tests, including the 30-second Chair Stand test (30CST) and the Timed Up-and-Go test (TUG), were recorded. Participants were randomly divided into two groups: a control group receiving oral advice on diet and exercise, and an intervention group receiving educational videos on nutrition, lifestyle changes, physical activity, individualised exercises, and psychosocial support. Evaluations were repeated after 8 weeks. RESULTS Data from 25 of 30 participants were analysed. In the intervention group, body composition, waist, and abdominal circumference decreased significantly (p < 0.05). The KOOS questionnaire showed significant improvements in pain, activity, and daily tasks (p = 0.00). The EQ5D questionnaire and health satisfaction also showed positive results within the intervention group (p = 0.00) and between groups (p = 0.008). The pain index improved significantly within (p = 0.00) and between groups (p = 0.02). Functional test results were significant within the intervention group (p = 0.00) and between groups (p = 0.017 for 30CST and p = 0.004 for TUG). CONCLUSION An 8-week tele-education programme for weight control and exercise therapy in knee OA patients significantly improved body composition, quality of life, and functional performance. Given the costs of obesity and knee OA on both people and the health system, tele-education can be a cost-effective treatment strategy.
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Affiliation(s)
- Reyhaneh Khazaei
- Sports and Exercise Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Maleklou
- Sports and Exercise Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Bodaghabadi
- Sports and Exercise Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Tavana
- Sports and Exercise Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Stefan Kluzek
- Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Sayedeh Elham Sharafi
- Psychosomatic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Alizadeh
- Sports and Exercise Medicine Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Shariq K, Siddiqi TJ, Van Spall H, Greene SJ, Fudim M, DeVore AD, Pandey A, Butler J, Khan MS. Role of telemedicine in the management of obesity: State-of-the-art review. Obes Rev 2024; 25:e13734. [PMID: 38528833 DOI: 10.1111/obr.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
Obesity is a worsening public health epidemic that remains challenging to manage. Obesity substantially increases the risk of cardiovascular diseases and presents a significant financial burden on the healthcare system. Digital health interventions, specifically telemedicine, may offer an attractive and viable solution for managing obesity. During the COVID-19 pandemic, the need for a safer alternative to in-person visits led to the increased popularity of telemedicine. Multiple studies have tested the efficacy of telemedicine modalities, including digital coaching via videoconferencing sessions, e-health monitoring using wearable devices, and asynchronous forms of communication such as online chatrooms with counselors. In this review, we discuss the available evidence for telemedicine interventions in managing obesity, review current challenges and barriers to using telemedicine, and outline future directions to optimize the management of patients with obesity using telemedicine.
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Affiliation(s)
- Kainat Shariq
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Tariq Jamal Siddiqi
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississipi, USA
| | - Harriette Van Spall
- Division of Cardiology, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton, Canada
| | - Stephen J Greene
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Marat Fudim
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Adam D DeVore
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississipi, USA
- Baylor Scott and White Research Institute, Dallas, Texas, USA
| | - Muhammad Shahzeb Khan
- Division of Cardiology, Duke University School of Medicine, Durham, North Carolina, USA
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Adebile TV, Adebile TM, Oloyede TF, Asifat OA, Biswas P, Sejoro S, Kersey JX. Telemedicine for obesity management among United States adults: A systematic and meta-analysis of intervention studies. J Telemed Telecare 2024:1357633X241247240. [PMID: 38632958 DOI: 10.1177/1357633x241247240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Obesity is projected to affect 86% of United States adults by 2030. Recent data show a surge to 41.9%, with the highest proportion in the 40-59 age group (44.3%). Obesity is linked to various health issues and preventable deaths. Telemedicine has emerged as a promising avenue for addressing obesity. This systematic review and meta-analysis examine the effectiveness of telemedicine interventions for managing obesity in US adults aged 40 and above. Through a thorough Preferred Reporting Items for Systematic Reviews and Meta-Analysis-guided search, 16 studies meeting inclusion criteria were identified. These studies employed diverse telemedicine technologies, including video-based and telephone sessions or a mixture of technologies. The analysis reveals a statistically significant mean difference of 0.93 in favor of telemedicine interventions for weight loss. Subgroup analysis suggests that intervention durations of 6-12 months and telephone-based sessions correlate with more substantial mean differences. This study provides valuable insights into the effectiveness of telemedicine in managing obesity, emphasizing the importance of intervention type and duration. Study limitations include variability and potential biases. Customized telemedicine strategies have the potential to combat the obesity epidemic among older adults in the United States, offering guidance to healthcare professionals aiming to reduce health risks and enhance overall well-being.
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Affiliation(s)
- Tolulope V Adebile
- Department of Biostatistics, Epidemiology and Environmental Health Sciences (BEES), Jiann-Ping Hsu College of Public Health (JPHCOPH), Georgia Southern University, Statesboro, GA, USA
| | | | - Tobi F Oloyede
- Department of Health Policy & Community Health, Georgia Southern University, Statesboro, GA, USA
| | - Olamide A Asifat
- Department of Biostatistics, Epidemiology and Environmental Health Sciences (BEES), Jiann-Ping Hsu College of Public Health (JPHCOPH), Georgia Southern University, Statesboro, GA, USA
| | - Purbasha Biswas
- Department of Biostatistics, Epidemiology and Environmental Health Sciences (BEES), Jiann-Ping Hsu College of Public Health (JPHCOPH), Georgia Southern University, Statesboro, GA, USA
| | - Sarah Sejoro
- Department of Biostatistics, Epidemiology and Environmental Health Sciences (BEES), Jiann-Ping Hsu College of Public Health (JPHCOPH), Georgia Southern University, Statesboro, GA, USA
| | - Jing X Kersey
- Department of Biostatistics, Epidemiology and Environmental Health Sciences (BEES), Jiann-Ping Hsu College of Public Health (JPHCOPH), Georgia Southern University, Statesboro, GA, USA
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Bayram F, Sonmez A, Kiyici S, Akbas F, Yetgin MK, Yazici D, Cingi A, Sargin M, Unal S, Iseri C, Mahmutoglu FS, Yumuk VD. Expert Opinion on the Utility of Telemedicine in Obesity Care: Recommendations on a Hybrid Multidisciplinary Integrated Care Follow-Up Algorithm. Curr Obes Rep 2024; 13:167-182. [PMID: 38172478 DOI: 10.1007/s13679-023-00541-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW The proposed expert opinion was prepared by a panel of obesity and law specialists from Turkey to review the utility of telemedicine in obesity care and to provide a guidance document with recommendations on a hybrid multidisciplinary integrated care follow-up algorithm and the legislation governing telemedicine practice to assist obesity specialists in practicing the telemedicine. RECENT FINDINGS The efficacy and feasibility of telemedicine interventions in supporting obesity management programs even during pandemics confirm that obesity is a particularly well-suited field for telemedicine, emphasizing the strong likelihood of continued utilization of telemedicine in obesity management, beyond the pandemic period. Telemedicine has great potential to address several barriers to ongoing weight-management care, such as challenges of access to specialized care, cost, and time limitations as well as patient adherence to treatment. However, telemedicine practice should complement rather than replace the in-person visits which are unique in building rapport and offering social support. Accordingly, the participating experts recommend the use of a hybrid integrated care model in the management of obesity, with the use of telemedicine, as an adjunct to in-person visits, to enable the provision of suggested intensive obesity management via frequent visits by a multidisciplinary team of obesity specialists. Further research addressing the utility of telemedicine in terms of optimal modality and duration for successful long-term obesity management outcomes is necessary to develop specific guidelines on telemedicine practice. In addition, the legislation governing the norms and protocols on confidentiality, privacy, access, and liability needs to be improved.
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Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Ankara Guven Hospital, Ankara, Turkey
| | - Sinem Kiyici
- Department of Endocrinology and Metabolism, University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
| | - Feray Akbas
- Department of Internal Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Meral Kucuk Yetgin
- Department of Coaching Education, Sport Health Sciences, Marmara University Faculty of Sports Science, Istanbul, Turkey
| | - Dilek Yazici
- Department of Endocrinology and Metabolism, Koc University Faculty of Medicine, Istanbul, Turkey
| | - Asim Cingi
- Department of General Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Sargin
- Department of Family Medicine, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Seniz Unal
- Private Clinical Psychology Office, Istanbul, Turkey
| | - Ceren Iseri
- Department of Internal Medicine, Nutrition Science, Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Fatih Selami Mahmutoglu
- Department of Criminal Law and Criminal Procedure Law, Turkish-German University Faculty of Law, Istanbul, Turkey
| | - Volkan Demirhan Yumuk
- Department of Endocrinology and Metabolism, Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey
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Rivera BD, Nurse C, Shah V, Roldan C, Jumbo AE, Faysel M, Levine SR, Kaufman D, Afable A. Do digital health interventions hold promise for stroke prevention and care in Black and Latinx populations in the United States? A scoping review. BMC Public Health 2023; 23:2549. [PMID: 38129850 PMCID: PMC10734160 DOI: 10.1186/s12889-023-17255-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Black and Latinx populations are disproportionately affected by stroke and are likely to experience gaps in health care. Within fragmented care systems, remote digital solutions hold promise in reversing this pattern. However, there is a digital divide that follows historical disparities in health. Without deliberate attempts to address this digital divide, rapid advances in digital health will only perpetuate systemic biases. This study aimed to characterize the range of digital health interventions for stroke care, summarize their efficacy, and examine the inclusion of Black and Latinx populations in the evidence base. METHODS We searched PubMed, the Web of Science, and EMBASE for publications between 2015 and 2021. Inclusion criteria include peer-reviewed systematic reviews or meta-analyses of experimental studies focusing on the impact of digital health interventions on stroke risk factors and outcomes in adults. Detailed information was extracted on intervention modality and functionality, clinical/behavioral outcome, study location, sample demographics, and intervention results. RESULTS Thirty-eight systematic reviews met inclusion criteria and yielded 519 individual studies. We identified six functional categories and eight digital health modalities. Case management (63%) and health monitoring (50%) were the most common intervention functionalities. Mobile apps and web-based interventions were the two most commonly studied modalities. Evidence of efficacy was strongest for web-based, text-messaging, and phone-based approaches. Although mobile applications have been widely studied, the evidence on efficacy is mixed. Blood pressure and medication adherence were the most commonly studied outcomes. However, evidence on the efficacy of the various intervention modalities on these outcomes was variable. Among all individual studies, only 38.0% were conducted in the United States (n = 197). Of these U.S. studies, 54.8% adequately reported racial or ethnic group distribution. On average, samples were 27.0% Black, 17.1% Latinx, and 63.4% White. CONCLUSION While evidence of the efficacy of selected digital health interventions, particularly those designed to improve blood pressure management and medication adherence, show promise, evidence of how these interventions can be generalized to historically underrepresented groups is insufficient. Including these underrepresented populations in both digital health experimental and feasibility studies is critical to advancing digital health science and achieving health equity.
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Affiliation(s)
- Bianca D Rivera
- School of Public Health, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
| | - Claire Nurse
- School of Public Health, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Vivek Shah
- College of Medicine, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Chastidy Roldan
- College of Medicine, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Adiebonye E Jumbo
- School of Health Professions, Health Informatics Program, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Mohammad Faysel
- School of Health Professions, Health Informatics Program, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Steven R Levine
- Department of Neurology/Stroke Center, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - David Kaufman
- School of Health Professions, Health Informatics Program, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | - Aimee Afable
- School of Public Health, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
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6
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Kupila SKE, Joki A, Suojanen LU, Pietiläinen KH. The Effectiveness of eHealth Interventions for Weight Loss and Weight Loss Maintenance in Adults with Overweight or Obesity: A Systematic Review of Systematic Reviews. Curr Obes Rep 2023; 12:371-394. [PMID: 37354334 PMCID: PMC10482795 DOI: 10.1007/s13679-023-00515-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE OF REVIEW: The purpose of this study is to evaluate the effectiveness of eHealth interventions for weight loss and weight loss maintenance among adults with overweight or obesity through a systematic review of systematic reviews. RECENT FINDINGS: This study included 26 systematic reviews, covering a total of 338 original studies, published between 2018 and 2023. The review indicates that eHealth interventions are more effective than control interventions or no care and comparable to face-to-face interventions. The effect sizes remain relatively small when comparing eHealth interventions to any control conditions, with mean differences of weight loss results from - 0.12 kg (95% CI - 0.64 to 0.41 kg) in a review comparing eHealth interventions to face-to-face care to - 4.32 kg (- 5.08 kg to - 3.57 kg) in a review comparing eHealth interventions to no care. The methodological quality of the included studies varies considerably. However, it can be concluded that interventions with human contact work better than those that are fully automated. In conclusion, this systematic review of systematic reviews provides an updated understanding of the development of digital interventions in recent years and their effectiveness for weight loss and weight loss maintenance among adults with overweight or obesity. The findings suggest that eHealth interventions can be a valuable tool for delivering obesity care to more patients economically. Further research is needed to determine which specific types of eHealth interventions are most effective and how to best integrate them into clinical practice.
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Affiliation(s)
- Sakris K E Kupila
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Anu Joki
- HealthyWeightHub, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura-U Suojanen
- HealthyWeightHub, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- HealthyWeightHub, Endocrinology, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Bricker JB, Mull KE, Sullivan BM, Forman EM, Lillis J, McTiernan A, Santiago-Torres M. Telehealth acceptance and commitment therapy for weight loss: Protocol of the WeLNES full scale randomized controlled trial. Contemp Clin Trials 2023; 126:107091. [PMID: 36682490 PMCID: PMC9998365 DOI: 10.1016/j.cct.2023.107091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/05/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Behavioral interventions delivered via one-on-one telephone coaching (hereafter referred to as telehealth) for weight loss have had great population-level reach but to date limited efficacy. Acceptance and Commitment Therapy (ACT) has promise to improve behavioral weight loss treatment efficacy by addressing the fundamental challenges of weight loss and maintenance: overeating in response to internal (e.g., stress) and external (e.g., high calorie foods) cues. Here we describe the Weight Loss, Nutrition, and Exercise Study (WeLNES) randomized controlled trial that is testing the efficacy of an ACT-based telehealth coaching intervention for weight loss in comparison to a Standard Behavioral Therapy (SBT)-based telehealth coaching intervention. A total of 398 adults with overweight or obesity are being recruited and randomized to either ACT or SBT telehealth coaching. Participants in both arms are offered twenty-five telehealth coaching sessions in year one and nine booster sessions in year two. All participants receive a Bluetooth-enabled scale to self-monitor weight and a Fitbit Inspire + Fitbit app for tracking diet and physical activity. The primary aim is to determine whether a greater proportion of ACT participants will achieve a clinically significant weight loss of ≥10% compared with SBT participants at 12-months. Secondary outcomes include change in weight from baseline to 6, 12, and 24-months. Whether the effect of ACT on weight loss is mediated by ACT processes and is moderated by baseline factors will also be examined. If ACT proves efficacious, ACT telehealth coaching will offer an effective, broadly scalable weight loss treatment-thereby making a high public health impact.
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Affiliation(s)
- Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA; University of Washington, Department of Psychology, Seattle, WA, USA
| | - Kristin E Mull
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA
| | - Brianna M Sullivan
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA
| | - Evan M Forman
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, PA, USA
| | - Jason Lillis
- Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA; College of Psychology, California Northstate University, Elk Grove, CA, USA
| | - Anne McTiernan
- Fred Hutchinson Cancer Center, Division of Public Health Sciences, Seattle, WA, USA; University of Washington School of Public Health, Department of Epidemiology, USA; University of Washington School of Medicine, Department of Medicine, USA
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8
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Fraticelli F, Nicola MD, Vitacolonna E. A nutritional web-based approach in obesity and diabetes before and during the COVID-19 lockdown. J Telemed Telecare 2023; 29:91-102. [PMID: 33081596 PMCID: PMC9816630 DOI: 10.1177/1357633x20966933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Obesity and type 2 diabetes (T2D) are two closely related pandemic conditions. Novel technologies represent promising tools for their management, the use of which has been greatly encouraged during the COVID-19 pandemic. The aim of the present study is to compare a web-based nutritional intervention versus a traditional one, before and during the Italian 'lockdown' period due to the COVID-19 outbreak, in overweight and obese subjects affected by T2D or impaired glucose regulation (IGR). METHODS For the study, 36 subjects were randomly allocated into two arms: a traditional arm, providing face-to-face individual and group-based intervention; and a web arm, deploying the in-presence traditional approach with intervention provided through web technologies. The outcomes were the data resulting from the comparison between the subjects' anthropometric and clinical parameters as well as PREDIMED scores at baseline with those at 3 months (T3), 6 months (T6) and at lockdown. RESULTS In the web arm we detected a progressive reduction in weight and body mass index (BMI) from baseline to T6 and a minimal increase of both parameters during the lockdown. Improvement of these parameters compared with baseline was observed in controls during the lockdown. The PREDIMED score improved at T6 compared with baseline in both arms. Significant variations were observed considering weight (p < 0.001), BMI (p = 0.001) and PREDIMED scores (p = 0.023) over time. DISCUSSION The study showed the effectiveness and feasibility of a short-term nutritional web-based intervention in patients affected by T2D or IGR before and during the COVID 19 pandemic.Clinical Trial registration number: NCT04386200, ClinicalTrials.gov.
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Affiliation(s)
- Federica Fraticelli
- Department of Medicine and Aging,
School of Medicine and Health Sciences, “G. d’Annunzio” University of
Chieti-Pescara, Italy
| | - Marta Di Nicola
- Laboratory of Biostatistics,
Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio”
University of Chieti-Pescara, Italy
| | - Ester Vitacolonna
- Department of Medicine and Aging,
School of Medicine and Health Sciences, “G. d’Annunzio” University of
Chieti-Pescara, Italy,Ester Vitacolonna, MD, Department of
Medicine and Aging, School of Medicine and Health Sciences, “G. d'Annunzio”
University, Via dei Vestini 66100 Chieti, Chieti-Pescara, Chieti, Italy.
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9
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Hilty DM, Serhal E, Crawford A. A Telehealth and Telepsychiatry Economic Cost Analysis Framework: Scoping Review. Telemed J E Health 2023; 29:23-37. [PMID: 35639444 DOI: 10.1089/tmj.2022.0016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction: Despite a good evidence base for telepsychiatry (TP), economic cost analyses are infrequent and vary in quality. Methods: A scoping review was conducted based on the research question, "From the perspective of an economic cost analysis for telehealth and telepsychiatry, what are the most meaningful ways to ensure a study/intervention improved clinical care, provided value to participants, had population level impact, and is sustainable?" The search in seven databases focused on keywords in four concept areas: (1) economic cost analysis, (2) evaluation, (3) telehealth and telepsychiatry, and (4) quantifiable health status outcomes. The authors reviewed the full-text articles based on the inclusion (Medical Subject Headings [MeSH] of the keywords) and exclusion criteria. Results: Of a total of 2,585 potential references, a total of 99 articles met the inclusion criteria. The evaluation of telehealth and TP has focused on access, quality, patient outcomes, feasibility, effectiveness, outcomes, and cost. Cost-effectiveness, cost-benefit, and other analytic models are more common with telehealth than TP studies, and these studies show favorable clinical, quality of life, and economic impact. A standard framework for economic cost analysis should include: an economist for planning, implementation, and evaluation; a tool kit or guideline; comprehensive analysis (e.g., cost-effectiveness or cost-benefit) with an incremental cost-effectiveness ratio; measures for health, quality of life, and utility outcomes for populations; methods to convert outcomes into economic benefits (e.g., monetary, quality of adjusted life year); broad perspective (e.g., societal perspective); sensitivity analysis for uncertainty in modeling; and adjustments for differential timing (e.g., discounting and future costs). Conclusions: Technology assessment and economic cost analysis-such as effectiveness and implementation science approaches-contribute to clinical, training, research, and other organizational missions. More research is needed with a framework that enables comparisons across studies and meta-analyses.
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Affiliation(s)
- Donald M Hilty
- Northern California Veterans Administration Health Care System, Mather, California, USA.,Department of Psychiatry & Behavioral Sciences, UC Davis, Sacramento, California, USA
| | - Eva Serhal
- ECHO Ontario Mental Health and ECHO Ontario Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Allison Crawford
- ECHO Ontario Mental Health and ECHO Ontario Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
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10
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Bischoff G. [What is confirmed in the treatment of obesity?]. INNERE MEDIZIN (HEIDELBERG, GERMANY) 2022; 63:1219-1228. [PMID: 36282318 DOI: 10.1007/s00108-022-01420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Obesity is a chronic disease. Obesity and the associated sequelae not only lead to an increased morbidity and mortality but also to a reduced quality of life. People with obesity are often stigmatized and are not offered adequate professional treatment although evidence-based treatment options are available. According to current guidelines a multimodal, interdisciplinary and individualized obesity treatment must always be carried out. For most patients with advanced obesity structured multimodal therapy programs and/or bariatric surgery (with accompanying conservative measures) are the treatment of choice. The treatment spectrum is supplemented by pharmaceuticals, supportive fields and online offers. As obesity is a chronic disease any time-limited treatment is mostly futile. Treatment of obesity must therefore be organized in a professional and long-term manner.
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Affiliation(s)
- Gert Bischoff
- ZEP - Zentrum für Ernährungsmedizin und Prävention, Klinik für Innere Medizin I, Krankenhaus Barmherzige Brüder, Romanstraße 93, 80639, München, Deutschland.
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11
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Effectiveness of a 12-Month Online Weight Reduction Program in Cohorts with Different Baseline BMI-A Prospective Cohort Study. Nutrients 2022; 14:nu14163281. [PMID: 36014787 PMCID: PMC9416047 DOI: 10.3390/nu14163281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022] Open
Abstract
The purpose of this article was to answer the question of whether people who want to reduce their body weight can achieve different results depending on their baseline BMI and whether the rate of weight loss is constant over the months of intervention. The study included 400 individuals aged 19 to 55 years with a mean BMI of 31.83 ± 4.77 (min 25.1 max 51.8). Men comprised 190 subjects and women 210 subjects. The participants were divided into three groups with the following BMI: overweight, class 1 obesity, and obesity class > 1 (class 2 and 3 combined). BMI groups were randomized by gender, the number of trainings per week, training time, intervention length, and intervention type. The online intervention consisted of a 15% energy deficit diet and training. Over the 12-month dietary intervention, overweight subjects reduced average body weight by 16.6%. The group with class 1 obesity reduced body weight by 15.7%. The group with obesity class > 1 reduced mean body weight by 15.4%. The relative weight reduction in the overweight group was significantly greater than in the other obesity groups (p = 0.007). In all groups, the rate of weight loss from month-to-month was statistically significant (p = 0.0001), ranging between 0.6 and 2.6% per month. The results indicate that overweight individuals are likely to experience a percent greater weight loss as a result of a comprehensive lifestyle intervention. Regardless of baseline BMI, the observed weight loss was consistent from month-to-month throughout the 12-month period, which may indicate that the diet, as well as, the training plan were properly tailored to the subjects’ needs and that they were highly motivated to participate in the program throughout its course. Properly conducted lifestyle intervention enables significant weight loss regardless of baseline BMI values.
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12
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de Arriba Muñoz A, García Castellanos MT, Cajal MD, Beisti Ortego A, Ruiz IM, Labarta Aizpún JI. Automated growth monitoring app (GROWIN): a mobile Health (mHealth) tool to improve the diagnosis and early management of growth and nutritional disorders in childhood. J Am Med Inform Assoc 2022; 29:1508-1517. [PMID: 35799406 DOI: 10.1093/jamia/ocac108] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/03/2022] [Accepted: 06/24/2022] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To assess the functionality and feasibility of the GROWIN app for promoting early detection of growth disorders in childhood, supporting early interventions, and improving children's lifestyle by analyzing data collected over 3 years (2018-2020). METHODS We retrospectively assessed the growth parameters (height, weight, body mass index [BMI], abdominal circumference) entered by users (caregivers/parents) in the GROWIN app. We also analyzed the potential health problems detected and the messages/recommendations the app showed. Finally, we assessed the possible impact/benefit of the app on the growth of the children. RESULTS A total of 21 633 users (Spanish [65%], Latin American [30%], and others [5%]) entered 10.5 ± 8.3 measurements (0-15 y old). 1200 recommendations were for low height and 550 for low weight. 1250 improved their measurements. A specialist review was recommended in 500 patients due to low height. 2567 nutrition tests were run. All children with obesity (n = 855, BMI: 27.8 kg/m2 [2.25 SD]) completed the initial test with a follow-up of ≥1 year. Initial results (score: 8.1) showed poor eating habits (fast food, commercially baked goods, candy, etc.), with >90% not having breakfast. After 3-6 months, BMI decreased ≥1 point, and test scores increased ≥2 points. This benefit was maintained beyond 1 year and was correlated with an improvement in BMI (r = -.65, P = .01). DISCUSSION/CONCLUSIONS The GROWIN app represents an innovative automated solution for families to monitor growth. It allows the early detection of abnormal growth indicators during childhood and adolescence, promoting early interventions. Additionally, in children with obesity, an improvement in healthy nutritional habits and a decrease in BMI were observed.
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Affiliation(s)
- Antonio de Arriba Muñoz
- Pediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - María Teresa García Castellanos
- Pediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Mercedes Domínguez Cajal
- Pediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Anunciación Beisti Ortego
- Pediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Ignacio Martínez Ruiz
- Instituto Universitario de Investigación de Ingeniería de Aragón (I3A), Zaragoza University, Zaragoza, Spain.,eHWin New Technologies, Zaragoza, Spain
| | - José Ignacio Labarta Aizpún
- Pediatric Endocrinology, Hospital Universitario Miguel Servet, Zaragoza, Spain.,Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
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13
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Ben-Assuli O. Measuring the cost-effectiveness of using telehealth for diabetes management: A narrative review of methods and findings. Int J Med Inform 2022; 163:104764. [DOI: 10.1016/j.ijmedinf.2022.104764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
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14
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Hammersmith KJ, Thiel MC, Messina MJ, Casamassimo PS, Townsend JA. Connecting Medical Personnel to Dentists via Teledentistry in a Children's Hospital System: A Pilot Study. FRONTIERS IN ORAL HEALTH 2022; 2:769988. [PMID: 35048070 PMCID: PMC8757768 DOI: 10.3389/froh.2021.769988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/15/2021] [Indexed: 12/17/2022] Open
Abstract
Investigators evaluated feasibility, acceptability, and sustainability of a teledentistry pilot program within a children's hospital network between March, 2018, and April, 2019. The program connected dentists to medical personnel and patients being treated in urgent care clinics, a primary care clinic, and a freestanding emergency department via synchronous video consultation. Three separate but parallel questionnaires evaluated caregiver, medical personnel, and dentist perspectives on the experience. Utilization of teledentistry was very low (2%, 14/826 opportunities), but attitudes regarding this service were largely positive among all groups involved and across all survey domains. Uptake of new technology has barriers but teledentistry may be an acceptable service, especially in the case of dental trauma.
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Affiliation(s)
- Kimberly J Hammersmith
- Nationwide Children's Hospital, Columbus, OH, United States.,The Ohio State University College of Dentistry, Columbus, OH, United States
| | - Macaire C Thiel
- Nationwide Children's Hospital, Columbus, OH, United States.,The Ohio State University College of Dentistry, Columbus, OH, United States
| | - Matthew J Messina
- The Ohio State University College of Dentistry, Columbus, OH, United States
| | - Paul S Casamassimo
- Nationwide Children's Hospital, Columbus, OH, United States.,The Ohio State University College of Dentistry, Columbus, OH, United States
| | - Janice A Townsend
- Nationwide Children's Hospital, Columbus, OH, United States.,The Ohio State University College of Dentistry, Columbus, OH, United States
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15
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Abstract
Obesity is a complex, multi-factorial, chronic condition which increases the risk of a wide range of diseases including type 2 diabetes mellitus, cardiovascular disease and certain cancers. The prevalence of obesity continues to rise and this places a huge economic burden on the healthcare system. Existing approaches to obesity treatment tend to focus on individual responsibility and diet and exercise, failing to recognise the complexity of the condition and the need for a whole-system approach. A new approach is needed that recognises the complexity of obesity and provides patient-centred, multidisciplinary care which more closely meets the needs of each individual with obesity. This review will discuss the role that digital health could play in this new approach and the challenges of ensuring equitable access to digital health for obesity care. Existing technologies, such as telehealth and mobile health apps and wearable devices, offer emerging opportunities to improve access to obesity care and enhance the quality, efficiency and cost-effectiveness of weight management interventions and long-term patient support. Future application of machine learning and artificial intelligence to obesity care could see interventions become increasingly automated and personalised.
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16
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Kirk S, Ogata B, Wichert E, Handu D, Rozga M. Treatment of Pediatric Overweight and Obesity: Position of the Academy of Nutrition and Dietetics Based on an Umbrella Review of Systematic Reviews. J Acad Nutr Diet 2022; 122:848-861. [DOI: 10.1016/j.jand.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
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17
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Castrillón Liñan C, Alvarez Mayorga JH, Lozada-Urbano M. The effects of telenutrition in overweight and obese adults in a nutritional center in Lima, Peru. F1000Res 2021; 10:545. [PMID: 34950451 PMCID: PMC8666983 DOI: 10.12688/f1000research.53564.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background: COVID-19 pandemic has been challenging for health services and systems around the world, including Peru. A viable alternative in the telemedicine field to guarantee patient nutritional care is telenutrition. Telenutrition involves the interactive use of electronic information and telecommunications technologies to implement the nutrition care process with patients at a remote location. Information regarding the experience with this methodology and its potential effect on patients’ nutritional goals, does not exist in Peru. The aim of the study was to report the effect of the evaluation type (telenutrition vs. in-person) on weight, body mass index (BMI), waist circumference (WC) and relative fat mass (RFM) in overweight and obese adult patients.
Methods: This retrospective study included 100 eligible patients in a single nutritional center, from January 2019 to March 2021. Telenutrition and in-person continuous variables were compared with independent sample t-test or U Mann-Whitney test.
Results: There were significant differences in weight, BMI, WC and RFM by the end of follow-up period, in both evaluation modalities. Patients on the telenutrition group had a mean decrease of 6.80 ± 4.87 cm in WC, whereas the mean difference observed for the in-person group was 6.74 ± 4.55 cm. There were no significant differences in the changes of any anthropometric parameters when comparing both systems. Reductions were observed in weight (5.93 ± 3.88 kg vs. 4.92 ± 3.29 kg), BMI (2.23 ± 1.39 kg/ m2 vs. 1.83 ± 1.23 kg/ m2), WC (6.80 ± 4.87 cm vs. 6.74 ± 4.55 cm) and RFM (2.43 ± 1.78 vs. 2.63 ± 1.73) in telenutrition and in-person evaluation, respectively by the end of the follow-up period.
Conclusions: Telenutrition may be regarded as an alternative to in-person evaluation offering anthropometric changes and nutritional goals similar to those reported through the in-person modality, in overweight and obese adult people.
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Affiliation(s)
- Carolina Castrillón Liñan
- Universidad Nacional Mayor de San Marcos, Av Carlos Germán Amezaga # 375, Cercado de Lima, Lima, 15081, Peru.,Centro Nutricional Allikay, Calle de las Artes Norte 269A, San Borja Lima, 15037, Peru
| | - Jimy Henry Alvarez Mayorga
- Facultad de Medicina Humana, Universidad Peruana Cayetano Heredia, Av Honorio Delgado # 430, San Martín de Porres, Lima, 15102, Peru
| | - Michelle Lozada-Urbano
- South American Center for Education and Research in Public Health, Universidad Privada Norbert Wiener, Av. Arequipa # 444, Cercado de Lima, 15046, Peru
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18
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Zhang AAY, Chew NWS, Ng CH, Phua K, Aye YN, Mai A, Kong G, Saw K, Wong RCC, Kong WKF, Poh KK, Chan KH, Low AFH, Lee CH, Chan MYY, Chai P, Yip J, Yeo TC, Tan HC, Loh PH. Post-ST-Segment Elevation Myocardial Infarction Follow-Up Care During the COVID-19 Pandemic and the Possible Benefit of Telemedicine: An Observational Study. Front Cardiovasc Med 2021; 8:755822. [PMID: 34746268 PMCID: PMC8569238 DOI: 10.3389/fcvm.2021.755822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/27/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Infectious control measures during the COVID-19 pandemic have led to the propensity toward telemedicine. This study examined the impact of telemedicine during the pandemic on the long-term outcomes of ST-segment elevation myocardial infarction (STEMI) patients. Methods: This study included 288 patients admitted 1 year before the pandemic (October 2018–December 2018) and during the pandemic (January 2020–March 2020) eras, and survived their index STEMI admission. The follow-up period was 1 year. One-year primary safety endpoint was all-cause mortality. Secondary safety endpoints were cardiac readmissions for unplanned revascularisation, non-fatal myocardial infarction, heart failure, arrythmia, unstable angina. Major adverse cardiovascular events (MACE) was defined as the composite outcome of each individual safety endpoint. Results: Despite unfavorable in-hospital outcomes among patients admitted during the pandemic compared to pre-pandemic era, both groups had similar 1-year all-cause mortality (11.2 vs. 8.5%, respectively, p = 0.454) but higher cardiac-related (14.1 vs. 5.1%, p < 0.001) and heart failure readmissions in the pandemic vs. pre-pandemic groups (7.1 vs. 1.7%, p = 0.037). Follow-up was more frequently conducted via teleconsultations (1.2 vs. 0.2 per patient/year, p = 0.001), with reduction in physical consultations (2.1 vs. 2.6 per patient/year, p = 0.043), during the pandemic vs. pre-pandemic era. Majority achieved guideline-directed medical therapy (GDMT) during pandemic vs. pre-pandemic era (75.9 vs. 61.6%, p = 0.010). Multivariable Cox regression demonstrated achieving medication target doses (HR 0.387, 95% CI 0.164–0.915, p = 0.031) and GDMT (HR 0.271, 95% CI 0.134–0.548, p < 0.001) were independent predictors of lower 1-year MACE after adjustment. Conclusion: The pandemic has led to the wider application of teleconsultation, with increased adherence to GDMT, enhanced medication target dosing. Achieving GDMT was associated with favorable long-term prognosis.
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Affiliation(s)
- Audrey A Y Zhang
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Nicholas W S Chew
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kailun Phua
- Department of Medicine, National University Hospital, Singapore
| | - Yin Nwe Aye
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Aaron Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kalyar Saw
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore
| | - Raymond C C Wong
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - William K F Kong
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Kian-Keong Poh
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Koo-Hui Chan
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Adrian Fatt-Hoe Low
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chi-Hang Lee
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mark Yan-Yee Chan
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ping Chai
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - James Yip
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Huay-Cheem Tan
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Poay-Huan Loh
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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19
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Twells LK, Harris Walsh K, Blackmore A, Adey T, Donnan J, Peddle J, Ryan D, Farrell A, Nguyen H, Gao Z, Pace D. Nonsurgical weight loss interventions: A systematic review of systematic reviews and meta-analyses. Obes Rev 2021; 22:e13320. [PMID: 34378849 DOI: 10.1111/obr.13320] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/17/2022]
Abstract
Access to bariatric surgery to treat obesity is limited and has long wait times. Many adults are seeking nonsurgical weight loss support. Our study objective was to conduct a systematic review of nonsurgical weight loss interventions. PubMed, EMBASE, CINAHL, PsycInfo, and the CochraneLibrary were searched. Inclusion criteria were adults 18 + with a BMI > 25 enrolled in minimum a 3-month nonsurgical weight loss intervention. Studies were independently extracted and assessed for quality using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR2). Pooled analyses were extracted, graded for evidence quality, and summarized. A total of 1065 studies were assessed for eligibility; 815 screened and 236 full-texts assessed. Sixty-four meta-analyses met eligibility criteria: 1180 RCTs with 184,605 study participants. Studies were categorized as diets (n = 13), combination therapies (n = 10), alternative (n = 16), technology (n = 10), behavioral (n = 5), physical activity (n = 6), and pharmacotherapy (n = 3). In 80% of studies, significant weight losses were reported ranging from 0.34-8.73 k in favor of the intervention. The most effective nonsurgical weight loss interventions were diets, either low-carbohydrate or low-fat diets, followed for 6 months; combination therapy including meal replacements plus enhanced support; and pharmacotherapy followed for 12 months. Although significant weight losses were reported for other types of interventions such as physical activity and technology, the majority of studies reported weight losses less than 2 kgs.
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Affiliation(s)
- Laurie K Twells
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Kristin Harris Walsh
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Alicia Blackmore
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Tanis Adey
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Jennifer Donnan
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Justin Peddle
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Devonne Ryan
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Alison Farrell
- Health Sciences Library, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Hai Nguyen
- School of Pharmacy, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Zhiwei Gao
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Dave Pace
- Faculty of Medicine-Surgery, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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20
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Nucera E, Rizzi A, Chini R, Giangrossi S, Lohmeyer FM, Parrinello G, Musca T, Miggiano GAD, Gasbarrini A, Inchingolo R. Diet Intervention Study through Telemedicine Assistance for Systemic Nickel Allergy Syndrome Patients during the COVID-19 Pandemic. Nutrients 2021; 13:nu13082897. [PMID: 34445054 PMCID: PMC8402020 DOI: 10.3390/nu13082897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Restrictions due to the COVID-19 pandemic limited patients’ access to hospital care. The aims of this study were to assess dietary nutritional status, quality of life (QoL), and adherence to dietary therapy before and after 30-day personalized diet therapy through telenutrition tools in patients with systemic nickel allergic syndrome (SNAS). Methods: Each SNAS patient underwent the following allergological procedures: (a) face-to-face visit (nutritional visit and QoL evaluation) with prescription of one out of five personalized and balanced dietary plans different for calorie intake, (b) video call visit for dietary evaluation and assessment of adherence to diet after 15 days, and (c) video call visit for dietary and QoL evaluation and assessment of adherence to diet therapy after 30 days (end of study). Results: We enrolled 20 SNAS patients. After 15 and 30 days, we found a statistically significant improvement in anthropometric findings after diet therapy, a significant adherence rate to low-nickel diet (60% and 80%, respectively), and an improvement in QoL with an increase in almost all psychometric indices. Conclusions: Our study demonstrates that telenutrition can be a valid tool to monitor nutritional status and adherence to balanced low-Ni diet positively affecting QoL in SNAS patients during the COVID-19 pandemic.
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Affiliation(s)
- Eleonora Nucera
- UOSD Allergologia e Immunologia Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (E.N.); (A.R.); (R.C.); (G.P.)
- Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.A.D.M.); (A.G.)
| | - Angela Rizzi
- UOSD Allergologia e Immunologia Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (E.N.); (A.R.); (R.C.); (G.P.)
| | - Raffaella Chini
- UOSD Allergologia e Immunologia Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (E.N.); (A.R.); (R.C.); (G.P.)
| | - Sara Giangrossi
- UOC Nutrizione Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (S.G.); (T.M.)
| | | | - Giuseppe Parrinello
- UOSD Allergologia e Immunologia Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (E.N.); (A.R.); (R.C.); (G.P.)
| | - Tania Musca
- UOC Nutrizione Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (S.G.); (T.M.)
| | - Giacinto Abele Donato Miggiano
- Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.A.D.M.); (A.G.)
- UOC Nutrizione Clinica, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; (S.G.); (T.M.)
| | - Antonio Gasbarrini
- Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (G.A.D.M.); (A.G.)
- UOC Gastroenterologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Riccardo Inchingolo
- UOC Pneumologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-06-3015-6062
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21
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Carels RA, Miller JC, Shonrock AT, Byrd R, Haley E. Exploring the addition of self-compassion skills training to a behavioral weight loss program delivered using video conferencing software. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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22
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Brown V, Tran H, Downing KL, Hesketh KD, Moodie M. A systematic review of economic evaluations of web-based or telephone-delivered interventions for preventing overweight and obesity and/or improving obesity-related behaviors. Obes Rev 2021; 22:e13227. [PMID: 33763956 DOI: 10.1111/obr.13227] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/01/2021] [Accepted: 02/06/2021] [Indexed: 12/16/2022]
Abstract
Obesity prevention interventions with behavioral or lifestyle-related components delivered via web-based or telephone technologies have been reported as comparatively low cost as compared with other intervention delivery modes, yet to date, no synthesized evidence of cost-effectiveness has been published. This study aimed to conduct a systematic review of economic evaluations of obesity prevention interventions with a telehealth or eHealth intervention component. A systematic search of six academic databases was conducted through October 2020. Studies were included if they reported full economic evaluations of interventions aimed at preventing overweight or obesity, or interventions aimed at improving obesity-related behaviors, with at least one intervention component delivered by telephone (telehealth) or web-based technology (eHealth). Findings were reported narratively, based on the Consolidated Health Economic Evaluation Reporting Standards. Twenty-seven economic evaluations were included from 20 studies meeting the inclusion criteria. Sixteen of the included interventions had a telehealth component, whereas 11 had an eHealth component. Seventeen interventions were evaluated using cost-utility analysis, five with cost-effectiveness analysis, and five undertook both cost-effectiveness and cost-utility analyses. Only eight cost-utility analyses reported that the intervention was cost-effective. Comparison of results from cost-effectiveness analyses was limited by heterogeneity in methods and outcome units reported. The evidence supporting the cost-effectiveness of interventions with a telehealth or eHealth delivery component is currently inconclusive. Although obesity prevention telehealth and eHealth interventions are gaining popularity, more evidence is required on their effectiveness and cost-effectiveness.
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Affiliation(s)
- Vicki Brown
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
| | - Huong Tran
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
| | - Katherine L Downing
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Kylie D Hesketh
- Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Marj Moodie
- Deakin Health Economics, Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in the Early Prevention of Obesity in Childhood, University of Sydney, New South Wales, Australia
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23
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Bailly S, Fabre O, Legrand R, Pantagis L, Mendelson M, Terrail R, Tamisier R, Astrup A, Clément K, Pépin JL. The Impact of the COVID-19 Lockdown on Weight Loss and Body Composition in Subjects with Overweight and Obesity Participating in a Nationwide Weight-Loss Program: Impact of a Remote Consultation Follow-Up-The CO-RNPC Study. Nutrients 2021; 13:nu13072152. [PMID: 34201490 PMCID: PMC8308256 DOI: 10.3390/nu13072152] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we observed that the rate of weight loss was reduced during LD. This reduction was counterbalanced in participants involved in a remote consultation follow-up with a dose-effect response based on the number of remote consultations.
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Affiliation(s)
- Sébastien Bailly
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
- Correspondence:
| | - Odile Fabre
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Rémy Legrand
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Laurent Pantagis
- Groupe Éthique et Santé. Actiburo 1, Bâtiment A—100 Chemin de l’Aumône Vieille, 13400 Aubagne, France; (O.F.); (R.L.); (L.P.)
| | - Monique Mendelson
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Robin Terrail
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Renaud Tamisier
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, 1165 Copenhagen, Denmark;
| | - Karine Clément
- Nutrition Department, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, 75013 Paris, France;
- Nutrition and Obesities: Systemic Approaches (NutriOmics) Research Unit, Sorbonne Université, INSERM, 75013 Paris, France
| | - Jean-Louis Pépin
- HP2 Laboratory, Grenoble Alpes University, INSERM U1300 and Grenoble Alpes University Hospital, 38000 Grenoble, France; (M.M.); (R.T.); (R.T.); (J.-L.P.)
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24
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Seron P, Oliveros MJ, Gutierrez-Arias R, Fuentes-Aspe R, Torres-Castro RC, Merino-Osorio C, Nahuelhual P, Inostroza J, Jalil Y, Solano R, Marzuca-Nassr GN, Aguilera-Eguía R, Lavados-Romo P, Soto-Rodríguez FJ, Sabelle C, Villarroel-Silva G, Gomolán P, Huaiquilaf S, Sanchez P. Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview. Phys Ther 2021; 101:pzab053. [PMID: 33561280 PMCID: PMC7928601 DOI: 10.1093/ptj/pzab053] [Citation(s) in RCA: 203] [Impact Index Per Article: 67.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/20/2020] [Accepted: 01/11/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. METHODS We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts-where the intervention to be evaluated is telerehabilitation by physical therapy-were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures. RESULTS Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. CONCLUSIONS Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. IMPACT Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.
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Affiliation(s)
- Pamela Seron
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - María-Jose Oliveros
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Ruvistay Gutierrez-Arias
- Instituto Nacional del Tórax and Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello, Santiago, Chile
| | - Rocío Fuentes-Aspe
- Internal Medicine Department and CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Catalina Merino-Osorio
- Carrera de Kinesiología, Facultad de Medicina, Clínica Alemana- Universidad del Desarrollo, Santiago, Chile
| | - Paula Nahuelhual
- Departamento de Evaluación de Tecnologías Sanitarias y Salud Basada en Evidencia, Ministerios de Salud, Santiago, Chile
- Facultad de Medicina, Clínica Alemana de Santiago – Universidad del Desarrollo, Santiago, Chile
| | - Jacqueline Inostroza
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Yorschua Jalil
- Escuela de Kinesiología, Facultad de Ciencias de la Rehabilitación, Universidad Andres Bello
- Programa de Doctorado Ciencias Medicas, Pontificia Universidad Católica de Chile, Escuela de Medicina, Santiago, Chile
| | - Ricardo Solano
- Medical Specialties Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Gabriel N Marzuca-Nassr
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Raul Aguilera-Eguía
- Departamento de Salud Pública and Carrera de Kinesiología, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
| | - Pamela Lavados-Romo
- Departamento Ciencias Preclínicas, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Francisco J Soto-Rodríguez
- Internal Medicine Department, Faculty of Medicine, Universidad de La Frontera
- Facultad de Ciencias de la Salud, Carrera de Kinesiología, Universidad Autónoma de Chile, Temuco, Chile
| | - Cecilia Sabelle
- Universidad Santo Tomás, Temuco, Chile
- Servicio de Salud Araucanía Sur, Temuco, Chile
| | - Gregory Villarroel-Silva
- Departamento Ciencias de la Salud, Carrera de Kinesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Hospital Josefina Martínez, Santiago, Chile
| | | | - Sayen Huaiquilaf
- Pediatrics and Child surgery Department, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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25
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Xu Y, Ye H, Zhu Y, Du S, Xu G, Wang Q. The efficacy of mobile health in alleviating risk factors related to the occurrence and development of coronary heart disease: A systematic review and meta-analysis. Clin Cardiol 2021; 44:609-619. [PMID: 33724494 PMCID: PMC8119799 DOI: 10.1002/clc.23596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/28/2021] [Accepted: 03/08/2021] [Indexed: 12/19/2022] Open
Abstract
The association between the efficacy of mobile health and the occurrence and development of coronary heart disease (CHD) is still unclear. Mobile health can alleviate the risk factors for CHD. PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang, and VIP databases were searched from inception through May 28, 2020. Randomized controlled trials of the effect of mobile health in alleviating the risk factors of CHD's occurrence and development were included. Risks of bias were assessed by two independent reviewers by using the RevMan 5.3, GRADEpro, and RoB2.0 to generate findings. Meta-analyses were performed to investigate the effects of mobile health on risk factors for CHD. Subgroup analyses were conducted. Sixteen randomized controlled trials, including 3898 patients with CHD, were included. Meta-analysis results showed that mobile health can reduce BMI (mean difference [MD] = - 1.24, 95% CI = - 2.02 to - 0.45, p < .05), waist circumference (MD = - 4.40, 95% CI = - 4.72 to - 4.08, p < .00001), total cholesterol (TC) level (MD = - 0.43, 95% CI = - 0.64 to - 0.22, p < 0.00001), low-density lipoprotein cholesterol (LDL-C) level (MD = - 0.31, 95% CI = - 0.48 to - 0.15, p < .05), diastolic blood pressure (MD = - 2.01, 95% CI = - 3.40 to - 0.623, p < .05), and depression (MD = - 8.32, 95% CI = - 12.83 to - 3.81, p < .05) and increase high-density lipoprotein cholesterol level (MD = 0.16, 95% CI = 0.01 to 0.32, p < .05) with statistically significant differences. The results of subgroup analyses indicated that the simple mobile health intervention has more remarkable advantages in reducing BMI, TC, LDL-C, and systolic blood pressure than the complex mobile health intervention. Mobile health can alleviate the risk factors for CHD and has a certain effect on the prevention and recovery of CHD. Simple mobile health has a remarkable advantage. Limited by the quantity and quality of included studies, future research enrolling high-quality studies should be taken to verify the above conclusions.
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Affiliation(s)
- Yue Xu
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
| | - Hui Ye
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
| | - Yuan Zhu
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
| | - Shizheng Du
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
| | - Guihua Xu
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
| | - Qing Wang
- School of NursingNanjing university of Chinese MedicineNanjingJiangsu ProvinceChina
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26
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Gamble A, Beech BM, Wade BC, Sutton VD, Lim C, Sandridge S, Welsch MA. Telehealth Diabetes Prevention Intervention for the Next Generation of African American Youth: Protocol for a Pilot Trial. JMIR Res Protoc 2021; 10:e25699. [PMID: 33787504 PMCID: PMC8047807 DOI: 10.2196/25699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/07/2020] [Accepted: 12/18/2020] [Indexed: 11/13/2022] Open
Abstract
Background In 1999, type 2 diabetes mellitus (T2DM) was identified as an emerging epidemic in youth, and racial and ethnic minority youth were identified with high risk. Two decades later, no gold standard T2DM prevention intervention has been established for this population. Objective This study tests the efficacy of a telehealth diabetes prevention intervention for African American (AA) families with children with risk for T2DM. Concurrently, investigators aim to evaluate an implementation strategy for the uptake of the intervention by the University of Mississippi Medical Center’s (UMMC) pediatric weight management clinic. Methods This single-arm trial will enroll 20 parents with overweight or obesity of children (8-11 years) with overweight or obesity, both of whom are at risk for T2DM. Parents will meet in small groups (5 parents per group) weekly for 11 weeks and then monthly for 4 monthly maintenance sessions via videoconference using Wi-Fi–enabled iPads with cellular connectivity. The intervention will be adapted from the National Diabetes Prevention Program and Power to Prevent, a diabetes prevention program tailored for AA families. The same lifestyle intervention facilitated by a racially concordant lifestyle coach trained in the Diabetes Prevention Program will be delivered to all groups (n=4). Participants will be recruited in-person during patient encounters at the UMMC’s pediatric weight management clinic. Sessions will consist of dietary and physical activity behavior change strategies facilitated using problem-solving and goal-setting skills. The implementation strategy has 2 targets: the pediatric weight management clinic site and clinical team and parents of children at risk for T2DM engaged in intensive obesity treatment to prevent T2DM. The multifaceted implementation protocol includes 4 discrete strategies: creating a new clinical team, changing the service site, intervening with families, and promoting organizational readiness for change. Results Recruitment and enrollment began in December 2020, and the intervention is scheduled to be delivered to the first cohort of parents in March 2021. The results are expected to be submitted for publication beginning in November 2021 through 2022. The primary outcome measure for the pilot trial will include changes from baseline to 12 and 30 weeks in the child BMI z score and parent BMI. The implementation evaluation will include multiple measures of feasibility, acceptability, appropriateness, fidelity, and efficacy. This protocol was approved by the UMMC’s Institutional Review Board (#2020V0249). Conclusions The proposed intervention approach is supported by the scientific literature and is scalable given the current and future health care subsidies for telehealth. Findings from this pilot trial will begin to address critical barriers to defining a gold standard lifestyle intervention for AA families with children at risk for T2DM. If effective, the intervention could be feasibly disseminated to treat obesity and prevent T2DM in high-risk AA pediatric populations. International Registered Report Identifier (IRRID) PRR1-10.2196/25699
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Affiliation(s)
- Abigail Gamble
- Department of Preventive Medicine, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States.,Department of Pediatrics, School of Medicine, University of Mississippi Medical Center, Jackson, MS, United States.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
| | - Bettina M Beech
- Department of Health Systems and Population Health Science, College of Medicine, University of Houston, Houston, TX, United States
| | - Breanna C Wade
- Department of Preventive Medicine, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
| | - Victor D Sutton
- Department of Preventive Medicine, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States.,Office of Preventive Health and Health Equity, Mississippi State Department of Health, Ridgeland, MS, United States
| | - Crystal Lim
- Division of Psychology, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Shanda Sandridge
- Pediatric Gastroenterology, Children's Healthcare of Mississippi, Jackson, MS, United States
| | - Michael A Welsch
- Department of Population Health Science, John D Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
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27
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Bricker JB, Mull KE, Sullivan BM, Forman EM. Efficacy of telehealth acceptance and commitment therapy for weight loss: a pilot randomized clinical trial. Transl Behav Med 2021; 11:1527-1536. [PMID: 33787926 DOI: 10.1093/tbm/ibab012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Telehealth coaching for weight loss has high population-level reach but limited efficacy. To potentially improve on this limitation, the purpose of this study was to determine the preliminary efficacy of the first known telephone coaching acceptance and commitment therapy (ACT) intervention for weight loss. A two-arm, stratified, individually randomized pilot trial comparing ACT (n = 53) with standard behavioral therapy (SBT; n = 52) was used for this study. Both interventions were delivered in 25 telephone coaching calls (15-20 min each) over a 12 month period. Weight was measured at baseline and 3, 6, and 12 month postrandomization follow-ups. Recruited from 32 U.S. states, participants were of mean age 40.7, 42% male, 34% racial/ethnic minority, and mean baseline body mass index of 34.3. Fractions of 10% or more scale-reported weight loss: 15% for ACT versus 4% for SBT at 3 month follow-up (N = 86; odds ratio [OR] = 4.61; 95% confidence interval [CI]: 0.79, 26.83), 24% for ACT versus 13% for SBT at 6 month follow-up (N = 72; OR = 2.45; 95% CI: 0.65, 9.23), 30% for ACT versus 30% for SBT at 12 month follow-up (N = 57; OR = 0.93; 95% CI: 0.28, 3.09). Fractions of 10% or more self-reported weight loss at 12 month follow-up: 25% for ACT versus 15% for SBT (N = 75; OR = 2.38; 95% CI: 0.68, 8.34). The conclusion of the study was the preliminary evidence that telephone coaching ACT may be efficacious for weight loss.
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Affiliation(s)
- Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.,Department of Psychology, University of Washington, Seattle, WA 98195, USA
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Brianna M Sullivan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Evan M Forman
- Department of Psychology, and Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, PA 19104, USA
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28
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Jimenez A, de Hollanda A, Palou E, Ortega E, Andreu A, Molero J, Mestre C, Ibarzabal A, Obach A, Flores L, Cañizares S, Balibrea JM, Vidal J, Escarrabill J, Moize V. Psychosocial, Lifestyle, and Body Weight Impact of COVID-19-Related Lockdown in a Sample of Participants with Current or Past History of Obesity in Spain. Obes Surg 2021; 31:2115-2124. [PMID: 33486709 PMCID: PMC7826154 DOI: 10.1007/s11695-021-05225-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/09/2022]
Abstract
Purpose Home lockdown and isolation due to COVID-19 have been related to negative changes in mood, sleep, and eating behaviors. People with obesity are especially vulnerable to emotional eating and might be more prone to weight gain and negative outcomes during lockdown. Materials and Methods Individuals scheduled for an appointment at the Obesity Unit of a Tertiary Hospital between March 16 and June 21 (n=1230). An online survey was distributed on May 11. Multivariable logistic regression models and general linear models were used to assess the relationship between perceived COVID-19 threat, BS status, and outcome variables. Results Of the 603 (72.0% females, 39% aged >55 years) respondents, 223 (36.9%) were BS naïve (non-BS), 134 (22.2%) underwent BS within the two previous years (BS<2y), and 245 (40.6%) more than 2 years before (BS>2y). Participants worried about being infected by COVID-19 showed significantly larger changes in family contact (p=0.04), mood (p<0.01), sleep (p<0.01), dietary habits (p=0.05), purchases of unhealthy food (p=0.02), snacking (p=0.05), and physical activity (p=0.02). Non-BS and BS>2y participants reported greater impact of lockdown in mood (p<0.01), experienced more negative changes in dietary habits (p<0.01), and had a higher likelihood for weight gain (OR: 5.61, 95% CI: 3.0–10.46; OR: 5.45, 95% CI: 2.87–10.35, respectively) compared to BS<2y. Conclusions COVID-19 pandemic is having a substantial negative impact in our population affected by obesity. During lockdown, people more than 2 years before BS behave like people without history of BS. Strategies addressed to prevent negative metabolic outcomes in this population are urgently needed. Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05225-z.
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Affiliation(s)
- Amanda Jimenez
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Ana de Hollanda
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Eva Palou
- Patient Experience Forum, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Emilio Ortega
- Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain.,Endocrinology Department, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Alba Andreu
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Judit Molero
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Carla Mestre
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Ainitze Ibarzabal
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Amadeu Obach
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Lilliam Flores
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Silvia Cañizares
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Jose Maria Balibrea
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Josep Vidal
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain
| | - Joan Escarrabill
- Patient Experience Forum, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain
| | - Violeta Moize
- Obesity Unit, Hospital Clínic de Barcelona, c/Villarroel 170, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), c/ Rosellon, 149, 153, 08036, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5.Pabellón 11. Planta 0, 28029, Madrid, Spain.
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29
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Batsis JA, Petersen CL, Clark MM, Cook SB, Kotz D, Gooding TL, Roderka MN, Al-Nimr RI, Pidgeon D, Haedrich A, Wright KC, Aquila C, Mackenzie TA. Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity. BMC Geriatr 2021; 21:44. [PMID: 33435877 PMCID: PMC7801868 DOI: 10.1186/s12877-020-01978-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/21/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology. METHODS A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing to participants in their homes. Participants used a Fitbit Alta HR for remote monitoring with data feedback provided by the interventionists. An aerobic activity prescription was provided and monitored. RESULTS Mean age was 72.9±3.9 years (82% female). Baseline anthropometric measures of weight, BMI, and waist circumference were 97.8±16.3 kg, 36.5±5.2 kg/m2, and 115.5±13.0 cm, respectively. A total of 142 participants were screened (n=27 ineligible), and 53 consented. There were nine dropouts (17%). Overall satisfaction with the trial (4.7+ 0.6, scale: 1 (low) to 5 (high)) and with Fitbit (4.2+ 0.9) were high. Fitbit was worn an average of 81.7±19.3% of intervention days. In completers, mean weight loss was 4.6±3.5 kg or 4.7±3.5% (p< 0.001). Physical function measures of 30-s sit-to-stand repetitions increased from 13.5±5.7 to 16.7±5.9 (p< 0.001), 6-min walk improved by 42.0±77.3 m (p=0.005) but no differences were observed in gait speed or grip strength. Subjective measures of late-life function improved (3.4±4.7 points, p< 0.001). CONCLUSIONS A technology-based obesity intervention is feasible and acceptable to older adults with obesity and may lead to weight loss and improved physical function. CLINICAL TRIAL REGISTRATION Registered on Clinicaltrials.gov # NCT03104205 . Registered on April 7, 2017. First participant enrolled on October 1st, 2018.
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Affiliation(s)
- John A Batsis
- Division of Geriatric Medicine, School of Medicine, and Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 5017 Old Clinic Building, Chapel Hill, NC, 27599, USA.
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA.
| | | | - Matthew M Clark
- Mayo Clinic Rochester, Department of Psychiatry and Psychology, and Division of Endocrinology, Rochester, MN, USA
| | | | | | - Tyler L Gooding
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - Meredith N Roderka
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - Rima I Al-Nimr
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - Dawna Pidgeon
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - Ann Haedrich
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - K C Wright
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
| | - Christina Aquila
- Dartmouth-Hitchcock, Geisel School of Medicine, and The Dartmouth Institute for Health Policy, Hanover, NH, USA
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Abstract
With 6.1 million United States cases as of early September 2020, the coronavirus disease 2019 (COVID-19) pandemic is presenting unprecedented challenges to primary care. As a complex multifactorial chronic disease, obesity is a significant risk for severe COVID-19 complications associated with high morbidity and mortality. Sustainable lifestyle changes and weight loss can be effective to address obesity and its complications. With COVID-19 expected to persist for the foreseeable future, treatment and prevention of obesity is more imperative than ever. This report summarizes how obesity management and lifestyle counseling can be incorporated and applied in primary care during and beyond the COVID-19 pandemic.
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Tippin E. Telehealth and Impact on Pediatric Obesity. J Pediatr Nurs 2020; 55:270-271. [PMID: 32980195 DOI: 10.1016/j.pedn.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Giese KK. Coronavirus Disease 2019's Shake-up of Telehealth Policy: Application of Kingdon's Multiple Streams Framework. J Nurse Pract 2020; 16:768-770. [PMID: 32837405 PMCID: PMC7430271 DOI: 10.1016/j.nurpra.2020.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Providing care by telehealth has been an aspiration for many health care practices. However, regulatory barriers often prevented its implementation. The emergence of the COVID-19 virus provided a window of opportunity for federal policy change in telehealth during a national state of emergency. Telehealth policy is examined using Kingdon’s multiple streams (policy) framework. Evidence suggests the effectiveness of telehealth for the delivery of health care. Before coronavirus disease 2019 (COVID-19), widespread use of telehealth lagged related to reimbursement. The COVID-19 pandemic provided a window of opportunity for federal policy change in telehealth reimbursement.
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Tang J, James L, Howell M, Tong A, Wong G. eHealth Interventions for Solid Organ Transplant Recipients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Transplantation 2020; 104:e224-e235. [PMID: 32732828 DOI: 10.1097/tp.0000000000003294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Lack of support for self-management may contribute to adverse health outcomes. eHealth has the potential to support self-management, but evidence in solid organ transplantation remains unclear. This review aims to evaluate the benefits and harms of eHealth interventions to support self-management in solid organ transplant recipients. METHODS We searched Cochrane Central Register of Controlled Trials, MEDLINE, and Embase databases for randomized trials of eHealth interventions in solid organ transplant recipients. We calculated the risk ratios or standardized mean difference of outcomes, and summary estimates were determined using random-effects models. The Cochrane risk of bias tool and Grading of Recommendations, Assessment, Development, and Evaluations were used to assess trial quality. RESULTS Twenty-one trials from 6 countries involving 2114 participants were included. Compared with standard care, eHealth interventions improved medication adherence (risk ratio, 1.34; CI, 1.12-2.56; I = 75%) and self-monitoring behavior (risk ratio, 2.58; CI, 1.56-4.27; I = 0%) up to 12 mo posttransplant. The treatment effects were largely consistent across different subgroups except for intervention functionality and mode of delivery. The effects on other outcomes were uncertain. Nine trials reported harms. The overall risk of bias was considered high or unclear, and the quality of evidence was low to very low for all outcomes. CONCLUSIONS eHealth interventions may improve medication adherence and self-monitoring behavior in the short term, but high-quality intervention studies are needed to determine whether eHealth will improve long-term patient-relevant outcomes.
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Affiliation(s)
- James Tang
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Laura James
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, NSW, Australia
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Mehta P, Stahl MG, Germone MM, Nagle S, Guigli R, Thomas J, Shull M, Liu E. Telehealth and Nutrition Support During the COVID-19 Pandemic. J Acad Nutr Diet 2020; 120:1953-1957. [PMID: 32792328 PMCID: PMC7359781 DOI: 10.1016/j.jand.2020.07.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022]
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Kelly JT, Allman-Farinelli M, Chen J, Partridge SR, Collins C, Rollo M, Haslam R, Diversi T, Campbell KL. Dietitians Australia position statement on telehealth. Nutr Diet 2020; 77:406-415. [PMID: 32596950 PMCID: PMC7540717 DOI: 10.1111/1747-0080.12619] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
It is the position of Dietitians Australia that clients can receive high‐quality and effective dietetic services such as Medical Nutrition Therapy (MNT) delivered via telehealth. Outcomes of telehealth‐delivered dietetic consultations are comparable to those delivered in‐person, without requiring higher levels of additional training nor compromising quality of service provision. Dietitians Australia recommends that policy makers and healthcare funders broaden the recognition for telehealth‐delivered dietetic consultations as a responsive and cost‐effective alternative or complement to traditional in‐person delivery of dietetic services. The successful implementation of telehealth can help to address health and service inequalities, improve access to effective nutrition services, and support people with chronic disease to optimise their diet‐related health and well‐being, regardless of their location, income or literacy level, thereby addressing current inequities.
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Affiliation(s)
- Jaimon T Kelly
- Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, Gold Coast, Australia
| | - Margaret Allman-Farinelli
- Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Juliana Chen
- Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, The University of Sydney, Sydney, Australia
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Clare Collins
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | - Megan Rollo
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | - Rebecca Haslam
- Priority Research Centre in Physical Activity & Nutrition and School of Health Sciences, Faculty of Health and Medicine , The University of Newcastle, Callaghan, Australia
| | | | - Katrina L Campbell
- Menzies Health Institute Queensland, Faculty of Medicine, Griffith University, Gold Coast, Australia
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