A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom
Summary (2 min read)
- Obesity is a significant health and social problem that has reached pandemic levels.
- 6-8 Based on current trends, it is estimated that by 2050 over half of the UK adult population could be obese costing the NHS £9.7 billion and, when higher rates of sickness absence from work associated with being obese, and reduced productivity and overall costs to business are taken into account, £49.9 billion to society as a whole.
- UK National Institute for Health and Care Excellence (NICE) guidance on obesity highlights that the identified evidence did not appear to suggest that the health professional who provides advice and support was important, the key issues being whether the health professional is motivational and the maintenance of support to the patient.
- 17 While community pharmacy-based provision of weight management services has been limited in the UK, a number of studies have been conducted elsewhere.
- Among participants followed up at one year weight loss was marginally greater in GPs (0.8 kg) than in pharmacies (0.6 kg).
MATERIALS AND METHODS
- Providers of the programme were responsible for the recruitment of participants over the course of the programme (up to a maximum of 30 participants per provider).
- To provide an indication of the level of socioeconomic deprivation in the geographical area where the participant resided, the Indices of Multiple Deprivation (IMD) 2010 score2 for the Lower Layer Super Output Area (LSOA)3 corresponding to the participants’ postcodes were added to the dataset using data linking postcode to LSOA available in the UKBorders dataset.25-27.
- In addition to this monitoring, in conjunction with a member of staff at their provider, participants were set ‘realistic’ weight loss targets (a weekly weight loss of 0.5-1 kg per session with the aim of losing 5-10% of original weight by session 12) and lifestyle, behaviour, diet and activity were also assessed.
- To determine whether there were relationships between variables the following statistical tests were applied to the data:.
- A total of 451 individuals were recruited to the programme (i.e. attended at least one session).
- GP providers (n=268) recruited more participants than pharmacy providers (n=183).
- Overall, 86% of participants were female and the mean age of the cohort was 41 years.
- There was no statistically significant difference between the IMD 2010 score of the LSOA corresponding to the participants’ postcode between pharmacy participants and GP participants.
- Additionally, the ethnic composition of the two groups differed significantly (see Table 1).
- The mean number of sessions attended per participant in the programme was seven.
- Thirty seven per cent of participants attended the first twelve sessions and less than one-in-five participants attended all 15 available sessions.
- Attendance was uniformly better at pharmacy providers than at GP providers (see Table 2).
- At baseline, there was considerable heterogeneity in weight, BMI and waist circumference between participants recruited through pharmacies and those recruited through GP practices.
- When considering weight loss between session 12 and session 15, it is apparent that GP participants failed to maintain their weight status achieved at session 12 (recording a mean weight gain of 0.9%) whereas participants attending pharmacies continued to lose weight between session 12 and session 15 (a mean weight loss of 1.2%).
Costs of providing the service
- Table 5 shows the costs of delivering the programme.
- As the majority of payments were based on the number of sessions hosted and GP providers recruited more participants than pharmacy providers, total costs were higher for GP providers than for pharmacy providers.
- This was true throughout the course of the programme but the gap in costs between pharmacy and GP providers narrowed as participants continued through the programme to the point where there was no statistically significant difference in costs between providers among participants attending session 15.
- Again, this is a result of the larger number of participants recruited by GPs (thus allowing for distribution of, for example, training costs across a larger pool of participants).
- Four hundred and fifty one participants were recruited to the My Choice Weight Management Programme.
- GP providers recruited more participants than pharmacy providers.
- Completers attending the My Choice Weight Management Programme at pharmacies appeared to be more successful at maintaining weight loss after completion of session 12 than completers attending at GPs.
- At session 15, weight loss (both absolute and as a percentage value) and BMI reduction was higher among pharmacy completers than GP completers.
CONFLICT OF INTEREST
- This research was funded by a grant from the commissioning organisation (NHS Heart of Birmingham teaching Primary Care Trust).
- This organisation, which no longer exists, was a public body which was responsible for the commissioning and provision of primary care NHS services to the population of central Birmingham.
- The authors declare no personal conflicts of interest.
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Cites background from "A comparison of the provision of th..."
...The contribution that pharmacy can make has also been recognised by the United Kingdom’s government, with local primary care organisations commissioning pharmacies to provide enhanced weight management services ....
...than the cost for services provided in the general practitioner practice ....
Cites background or result from "A comparison of the provision of th..."
...Three studies had additional support from either general practitioners([30,33,35]) and/or dietitians....
...Four studies utilized between 12 and 34 pharmacies.([32,33,36,37]) One study did not specify how many pharmacies were involved in their study....
...3% to 79% (see Table 2).([30,32,33,36]) Four studies included some formal training of pharmacists in the administration of the weight management programme to patients....
...The Bush et al.() study did a 6-month poststudy follow-up and found an average of 1 kg of additional weight loss after the study was completed....
...There were five pre-/post-studies,([31,32,35,37,39]) two RCTs,([34,38]) one nonrandomised retrospective comparison() and one prospective cohort study....
Cites background from "A comparison of the provision of th..."
...These lasted up to 6 months or as long as 3 years [53,55,57,59,62,63,77,84,87,91-93,98,105,108,109,112]....
"A comparison of the provision of th..." refers background in this paper
...a healthcare assistant, practice nurse or pharmacy assistant) in an attempt to reduce weight via lifestyle modification (24)....
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Frequently Asked Questions (2)
Q1. What contributions have the authors mentioned in the paper "The my choice weight management programme 1 a comparison of the provision of the my choice weight management programme via general practitioner practices and community pharmacies in the united kingdom" ?
In this paper, a randomised controlled open-label trial conducted in a single community pharmacy in the United States was compared to the efficacy of a conventional reduced calorie diet.
Q2. What are the future works in "The my choice weight management programme 1 a comparison of the provision of the my choice weight management programme via general practitioner practices and community pharmacies in the united kingdom" ?
Any future research should examine whether the intervention is replicable in a larger cohort, over a longer period of time and attempt to account for any possible sampling bias and reduce the possibility of confounding via randomisation of participants to distinct control and intervention arms.