A systematic review of interventions to improve health professionals' management of obesity.
OBJECTIVE
To determine the existence and effectiveness of interventions to improve health professionals' management of obesity or the organisation of care for overweight and obese people.


METHODS
A systematic review of intervention studies, undertaken according to standard methods developed by the Cochrane Effective Practice and Organisation of Care (EPOC) Group.


METHODS
Trained health care professionals and overweight and obese patients.


METHODS
Objective measures of health professionals' practice and behaviours, and patient outcomes including satisfaction, behaviour, psychological factors, disease status, risk factors, and measures of body weight, fat, or BMI.


RESULTS
Twelve studies that met all the review inclusion criteria were identified. Three were randomised controlled trials of health professional-oriented interventions (such as the use of reminders and training) and one was a controlled before and after study to improve collaboration between a hospital clinic and GPs. A further eight randomised controlled trials were identified of interventions comparing either the deliverer of weight loss interventions or the setting of the delivery of the intervention. The heterogeneity and generally limited quality of identified studies make it difficult to provide recommendations for improving health professionals' obesity management.


CONCLUSIONS
At present, decisions about improving the provision of services for overweight and obese people must be based on the evidence from patient interventions and good clinical judgement. Future research is required to identify cost-effective strategies for improving health professionals' management and the organisation of care for overweight and obese people.
Harvey
E L
EL
Department of Health Sciences and Clinical Evaluation, Alcuin College, University of York, UK. elh4@york.ac.uk
Glenny
A M
AM
Kirk
S F
SF
Summerbell
C D
CD
D001835:Body Weight; D006801:Humans; D009765:Obesity / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss