Little, Paul, Stuart, Beth, Hobbs, F.D. Richard, Kelly, Joanne, Smith, Emily, Bradbury, Katherine, Hughes, Stephanie, Smith, Peter, Moore, Michael, Lean, Mike E.J., Margetts, Barrie, Byrne, Christopher, Griffin, Simon, Davoudianfar, Mina, Hooper, Julie, Yao, Guiqing, Zhu, Shihua, Raftery, James and Yardley, Lucy (2017) Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction). Health Technology Assessment, 21 (4), 1-61. (doi:10.3310/hta21040).
Abstract
Background: Obesity is increasing and causes major health problems. Intensive expert counselling about diet and exercise works, but there is limited capacity to do this in general practice, where most people are managed.
Methods: People in the ‘control’ group were give brief written advice plus 6-monthly follow-ups with a practice nurse. This was compared with an internet-based intervention called Positive Online Weight Reduction (POWeR+) to help change eating and exercise habits. Nurse support for POWeR+ was either by face-to-face support (up to seven contacts) or remote support (up to five e-mails or brief telephone calls).
Results: A total of 818 people took part. The control group lost nearly 3 kg per person over 12 months. Compared with the control group, participants in the face-to-face POWeR+ group lost 1.5 kg more, averaged over 12 months, whereas those in the the remote group lost 1.3 kg more. By 12 months, mean weight loss was not significantly different between groups, but 20.8% of the control group, 29.2% of the face-to-face group and significantly more of the remote group (32.4%) had lost ≥ 5% of their original body weight, which is important to health. Costs to the NHS were lowest for the remote group, who were generally doing fewer other activities to lose weight and felt more enabled to manage their weight. Interviews confirmed that patients generally liked POWeR+ and health-care professionals liked supporting patients to use POWeR+.
Conclusion: Compared with brief advice and occasional brief nurse follow-up, using an internet-based programme (POWeR+) combined with brief support by a practice nurse results in more people achieving an important amount of weight loss, and is cost-effective.
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