A SHARED CARE APPROACH IN OBESITY MANAGEMENT - THE GENERAL-PRACTITIONER AND A HOSPITAL-BASED SERVICE

OBJECTIVE: To describe the process of establishing a Shared Care obesi ty management programme between general practitioners and a hospital b ased specialist obesity service and to compare outcomes of the Shared Care programme (SC) to an established hospital based programme (MOS). DESIGN: A comparative study of two obesity management programmes, Pati ents were matched on gender. age and BMI (kg/m(2)). SUBJECTS: 29 femal e and eight male (age: 47.0 +/- 2 years, BMI 35.9 +/- 0.8 kg/m(2)) pat ients enrolled in the Shared Care programme (SC) were matched to 81 fe male and 20 male (age: 45.8 +/- 1.1 years. BMI 35.7 +/- 0.4 kg/m(2)) p atients enrolled in a hospital based programme (MOS). MAIN OUTCOME MEA SURES: Relative and absolute weight loss and retention rate were compa red between the programmes at 10 and 26 weeks, Food habits were assess ed at enrolment and week 10 of the programme in the SC group by a Food Habits Questionnaire and cognitive restraint. disinhibition and hunge r were assessed by the Eating Inventory Questionnaire, RESULTS: Shared Care patients (n = 28) lost significantly more weight than the MOS pa tients (n = 60) (SC 4.8 +/- 0.6 kg and MOS 2.6 +/- 0.4 kg; p = 0.0016) over the 10 weeks of the programme, At 26 weeks both groups demonstra ted a 5 kg weight loss, There was a significant improvement in food ha bits. and cognitive restraint, disinhibition and hunger over the 10 we eks of the programme in the SC group. Patient satisfaction was reflect ed in a better retention rate at 26 weeks by the Shared Care group. CO NCLUSION: The study demonstrated that the obese patient managed in a s hared care setting achieved better weight loss in the short term and a ttrition was lower in the longer term than a similar patient attending a specialist service based in a hospital.