Weight-management interventions in primary care: a pilot randomised controlled trial.
BACKGROUND
There is a paucity of randomised controlled trials of weight management in primary care.


OBJECTIVE
To ascertain the feasibility of a full trial of a nurse-led weight-management programme in general practice.


METHODS
Factorial randomised control trial.


METHODS
Primary care, UK.


METHODS
A total of 123 adults (80.3% women, mean age 47.2 years) with body mass index > or =27 kg/m(2), recruited from eight practices, were randomised to receive structured lifestyle support (n = 30), structured lifestyle support plus pedometer (n = 31), usual care (n = 31), or usual care plus pedometer (n = 31) for a 12-week period.


RESULTS
A total of 103 participants were successfully followed up. The adjusted mean difference in weight in structured support compared to usual care groups was -2.63 kg (95% confidence interval [CI] = -4.06 to -1.20 kg), and for pedometer compared to no pedometer groups it was -0.11 kg (95% CI = -1.52 to 1.30 kg). One in three participants in the structured-support groups (17/50, 34.0%) lost 5% or more of their initial weight, compared to less than one in five (10/53, 18.9%) in usual-care groups; provision of a pedometer made little difference (14/48, 29.2% pedometer; 13/55, 23.6% no pedometer). Difference in waist circumference change between structured-support and usual-care groups was -1.80 cm (95% CI = -3.39 to -0.20 cm), and between the pedometer and no pedometer groups it was -0.84 cm (95% CI = -2.42 to 0.73 cm). When asked about their experience of study participation, most participants found structured support helpful.


CONCLUSIONS
The structured lifestyle support package could make substantial contributions to improving weight-management services. A trial of the intervention in general practice is feasible and practicable.
Nanchahal
Kiran
K
London School of Hygiene and Tropical Medicine, London. kiran.nanchahal@lshtm.ac.uk
Townsend
Joy
J
Letley
Louise
L
Haslam
David
D
Wellings
Kaye
K
Haines
Andy
A
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000451:nursing / Q000517:prevention & control*; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss; D055815:Young Adult