Hospital Intervention to Reduce Overweight with Educational Reinforcement after Discharge: A Multicenter Randomized Clinical Trial.

Carmen Herrera-Espiñeira, María Del Carmen Martínez-Cirre, Manuel López-Morales, Antonia Lozano-Sánchez, Antonia Rodríguez-Ruíz, Laura Esther Salmerón-López, María Isabel Gómez-Crespo, Manuela Expósito-Ruíz

Journal: Nutrients 2022;14(12):2499

PMID: 35745229

Abstract

INTRODUCTION

Obesity and overweight affect more than one-third of the world's population and pose a major public health problem.

OBJECTIVE

To evaluate the impact of an educational intervention on dietary habits and physical exercise in patients with overweight admitted to departments of internal medicine, comprising a pre-discharge educational session with follow-up and reinforcement by telephone at 3, 6, and, 12 months post-discharge. Outcome variables were weight, systolic (SBP) and diastolic (DBP) blood pressures, health-related quality of life (HRQOL), hospital readmissions, emergency department visits, and death.

METHOD

A randomized experimental study with a control group was performed in hospitalized non-diabetic adults aged ≥18 years with body mass index (BMI) ≥25 Kg/m.

RESULTS AND CONCLUSIONS

The final sample included 273 patients. At three months post-discharge, the intervention group had lower SBP and DPB and improved dietary habits (assessed using the Pardo Questionnaire) and VAS-assessed HRQOL in comparison to the control group but a worse EQ-5Q-5L-assessed HRQOL. There were no between-group differences in hospital readmissions, emergency department visits, or mortality at any time point. Both groups evidenced a progressive improvement over the three follow-up periods in weight, SBP, and dietary habits but a worsening of EQ-5D-5L-value-assessed HRQOL.

DISCUSSION

The intervention group showed greater improvements over the short term, but between-group differences disappeared at 6 and 12 months. Weight loss and improvements in key outcomes were observed in both groups over the follow-up period. Further research is warranted to determine whether a minimum intervention with an educational leaflet, follow-up phone calls, and questionnaires on overweight-related healthy habits, as in the present control group, may be an equally effective strategy without specific individual educational input.

Address: Faculty of Health Sciences, University of Granada, 18012 Granada, Spain.; Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain.; National Network of Research in Health Departments and Chronic Diseases (REDISSEC), 18012 Granada, Spain.; Clinical Documentation Unit, Virgen de las Nieves University Hospital, 18014 Granada, Spain.; Faculty of Health Sciences, University of Granada, 18012 Granada, Spain.; Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain.; Granada-Metropolitan Health District, 18012 Granada, Spain.; Department of Internal Medicine, Baza Hospital, 18800 Baza, Spain.; Department of Internal Medicine, Motril Hospital, 18600 Motril, Spain.; Department of Internal Medicine, Virgen de las Nieves University Hospital, 18014 Granada, Spain.; Ceuta University Hospital, 51003 Ceuta, Spain.; Unit of Biostatistics, Department of Statistics, School of Medicine, University of Granada, 18012 Granada, Spain.
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