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1.
Am J Gastroenterol ; 113(1): 23-30, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29016559

RESUMEN

OBJECTIVES: Current healthcare systems do not effectively promote weight reduction in patients with obesity and gastroesophageal reflux disease (GERD). The Reflux Improvement and Monitoring (TRIM) program provides personalized, multidisciplinary, health education and monitoring over 6 months. In this study we aimed to (i) measure the effectiveness of TRIM on GERD symptoms, quality of life, and weight, and (ii) examine patient health beliefs related to TRIM. METHODS: This prospective mixed methods feasibility study was performed at a single center between September 2015 and February 2017, and included adult patients with GERD and a body mass index ≥30 kg/m2. Quantitative analysis consisted of a pre- to post-intervention analysis of TRIM participants (+TRIM Cohort) and a multivariable longitudinal mixed model analysis of +TRIM vs. patients who declined TRIM (-TRIM Cohort). Primary outcomes were change in patient-reported GERD symptom severity (GerdQ) and quality of life (GerdQ-DI), and change in percent excess body weight (%EBW). Qualitative analysis was based on two focus groups of TRIM participants. RESULTS: Among the +TRIM cohort (n=52), mean baseline GerdQ scores (8.7±2.9) decreased at 3 months (7.5±2.2; P<0.01) and 6 months (7.4±1.9; P=0.02). Mean GerdQ-DI scores decreased, but did not reach statistical significance. Compared with the -TRIM cohort (n=89), reduction in %EBW was significantly greater at 3, 6, and 12 months among the +TRIM cohort (n=52). In qualitative analysis, patients unanimously appreciated the multidisciplinary approach and utilized weight loss effectively to improve GERD symptoms. CONCLUSIONS: In this mixed methods feasibility study, participation in TRIM was associated with symptom improvement, weight reduction, and patient engagement.


Asunto(s)
Actitud Frente a la Salud , Reflujo Gastroesofágico/terapia , Obesidad/terapia , Planificación de Atención al Paciente , Educación del Paciente como Asunto , Participación del Paciente , Calidad de Vida , Programas de Reducción de Peso , Adulto , Anciano , Estudios de Factibilidad , Femenino , Grupos Focales , Gastroenterólogos , Reflujo Gastroesofágico/complicaciones , Educadores en Salud , Humanos , Masculino , Comidas , Informática Médica , Persona de Mediana Edad , Análisis Multivariante , Nutricionistas , Obesidad/complicaciones , Grupo de Atención al Paciente , Estudios Prospectivos , Investigación Cualitativa , Resultado del Tratamiento
2.
J Hosp Med ; 9(8): 515-20, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24854049

RESUMEN

BACKGROUND: Obesity-related comorbidities frequently contribute to acute illness. Obesity interventions during hospitalization are not often utilized but may be effective. OBJECTIVE: To examine whether inpatient weight loss intervention with postdischarge follow-up results in weight loss at 6 months when compared to control. DESIGN: Prospective, randomized controlled trial. SETTING: Academic medical center in Chicago, Illinois. PATIENTS: Obese adult inpatients. INTERVENTION: Intervention subjects viewed a weight education video, underwent personalized counseling, and set specific weight loss, dietary, and fitness goals prior to discharge. All participants were followed by phone over the subsequent 6 months. The trial was unblinded to participants, physicians, and investigators. MEASUREMENTS: Primary outcome was weight change between groups at 6 months. Weight change from baseline and waist-to-hip ratios (WHR) were also assessed. RESULTS: For 176 participants in the intention-to-treat analysis, mean baseline weight for the intervention group was 107.7 kg (standard deviation [SD]=16.7) and 105.1 kg (SD=17.4) for controls. Mean weight loss at 6 months was 1.08 kg (SD=4.33) for intervention subjects and 1.35 kg (SD=3.65) among controls. There was no significant difference in weight loss between groups at 6 months (P=0.26). As-treated analysis yielded similar results. There were no differences in WHRs between the intervention and control at 6 months (0.04 vs 0.04, P=0.59). CONCLUSIONS: We found no difference in weight loss between the intervention and control groups at 6 months.


Asunto(s)
Consejo/métodos , Pacientes Internos , Obesidad/terapia , Alta del Paciente/estadística & datos numéricos , Teléfono , Pérdida de Peso , Centros Médicos Académicos , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
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