Improving management of obesity in primary care: cluster randomised trial.
OBJECTIVE
To evaluate a training programme intended to improve the management of obesity, delivered to general practice teams.


METHODS
Cluster randomised trial.


METHODS
Northern and Yorkshire region of England.


METHODS
44 general practices invited consecutively attending obese adults to participate; 843 patients attended for collection of baseline data and were subsequently randomised.


METHODS
4.5 hour training programme promoting an obesity management model.


METHODS
Difference in weight between patients in intervention and control groups at 12 months (main outcome measure) and at 3 months and 18 months; change in practitioners' knowledge and behaviour in obesity management consultations.


RESULTS
Twelve months after training the patients in the intervention group were 1 (95% confidence interval--1.9 to 3.9) kg heavier than controls (P = 0.5). Some evidence indicated that practitioners' knowledge had improved. Some aspects of the management model, including recording weight, target weight, and dietary targets, occurred more frequently in intervention practices after the training, but in absolute terms levels of implementation were low.


CONCLUSIONS
A training package promoting a brief, prescriptive approach to the treatment of obesity through lifestyle modification, intended to be incorporated into routine clinical practice, did not ultimately affect the weight of this motivated and at risk cohort of patients.
Moore
Helen
H
Centre for Research in Primary Care, University of Leeds, Leeds LS2 9PL. h.moore@leeds.ac.uk
Summerbell
Carolyn D
CD
Greenwood
Darren C
DC
Tovey
Philip
P
Griffiths
Jacqui
J
Henderson
Maureen
M
Hesketh
Kate
K
Woolgar
Sally
S
Adamson
Ashley J
AJ
D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D004501:Education, Medical / Q000379:methods*; D005194:Family Practice / Q000193:education*; D005260:Female; D006266:Health Education; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control*; D016017:Odds Ratio; D011379:Prognosis