Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial
<p><strong>Background:</strong> There is evidence that commercially available behavioural weight management programmes can lead to short-term weight loss and reductions in glycaemia. Here, we aimed to provide the 5-year impact and cost-effectiveness of these interventions...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2022
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| _version_ | 1797109214538104832 |
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| author | Ahern, AL Breeze, P Fusco, F Sharp, SJ Islam, N Wheeler, GM Hill, AJ Hughes, CA Duschinsky, R Thomas, C Bates, S Woolston, J Stubbings, M Whittle, F Boothby, C Bostock, J Jebb, S Aveyard, P Boyland, E Halford, JCG Morris, S Brennan, A Griffin, SJ |
| author_facet | Ahern, AL Breeze, P Fusco, F Sharp, SJ Islam, N Wheeler, GM Hill, AJ Hughes, CA Duschinsky, R Thomas, C Bates, S Woolston, J Stubbings, M Whittle, F Boothby, C Bostock, J Jebb, S Aveyard, P Boyland, E Halford, JCG Morris, S Brennan, A Griffin, SJ |
| author_sort | Ahern, AL |
| collection | OXFORD |
| description | <p><strong>Background:</strong> There is evidence that commercially available behavioural weight management programmes can lead to short-term weight loss and reductions in glycaemia. Here, we aimed to provide the 5-year impact and cost-effectiveness of these interventions compared with a brief intervention.</p>
<p><strong>Methods:</strong> WRAP was a non-blinded, parallel-group randomised controlled trial (RCT). We recruited from primary care practices in England and randomly assigned participants to one of three interventions (brief intervention, 12-week open-group behavioural programme [WW, formerly Weight Watchers], or a 52-week open-group WW behavioural programme) in an uneven (2:5:5) allocation. Participants were followed up 5 years after randomisation using data from measurement visits at primary care practices or a research centre, review of primary care electronic medical notes, and self-report questionnaires. The primary outcome was change in weight at 5 years follow-up, assessed using analysis of covariance. We also estimated cost-effectiveness of the intervention. This study is registered at Current Controlled Trials, ISRCTN64986150.</p>
<p><strong>Findings:</strong> Between Oct 18, 2012, and Feb 10, 2014, we recruited 1269 eligible participants (two participants were randomly assigned but not eligible and therefore excluded) and 1040 (82%) consented to be approached about additional follow-up and to have their medical notes reviewed at 5 years. The primary outcome (weight) was ascertained for 871 (69%) of 1267 eligible participants. Mean duration of follow-up was 5·1 (SD 0·3) years. Mean weight change from baseline to 5 years was −0·46 (SD 8·31) kg in the brief intervention group, −1·95 (9·55) kg in the 12-week programme group, and −2·67 (9·81) kg in the 52-week programme. The adjusted difference in weight change was –1·76 (95% CI –3·68 to 0·17) kg between the 52-week programme and the brief intervention; –0·80 (–2·13 to 0·54) kg between the 52-week and the 12-week programme; and –0·96 (–2·90 to 0·97) kg between the 12-week programme and the brief intervention. During the trial, the 12-week programme incurred the lowest cost and produced the highest quality-adjusted life-years (QALY). Simulations beyond 5 years suggested that the 52-week programme would deliver the highest QALYs at the lowest cost and would be the most cost-effective. No participants reported adverse events related to the intervention.</p>
<p><strong>Interpretation:</strong> Although the difference in weight change between groups was not statistically significant, some weight loss was maintained at 5 years after an open-group behavioural weight management programme. Health economic modelling suggests that this could have important implications to reduce the incidence of weight-related disease and these interventions might be cost-saving.</p> |
| first_indexed | 2024-03-07T07:37:16Z |
| format | Journal article |
| id | oxford-uuid:fe4bca0f-a39d-4072-8ac7-139132c56d96 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:37:16Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:fe4bca0f-a39d-4072-8ac7-139132c56d962023-03-20T07:00:24ZEffectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fe4bca0f-a39d-4072-8ac7-139132c56d96EnglishSymplectic ElementsElsevier2022Ahern, ALBreeze, PFusco, FSharp, SJIslam, NWheeler, GMHill, AJHughes, CADuschinsky, RThomas, CBates, SWoolston, JStubbings, MWhittle, FBoothby, CBostock, JJebb, SAveyard, PBoyland, EHalford, JCGMorris, SBrennan, AGriffin, SJ<p><strong>Background:</strong> There is evidence that commercially available behavioural weight management programmes can lead to short-term weight loss and reductions in glycaemia. Here, we aimed to provide the 5-year impact and cost-effectiveness of these interventions compared with a brief intervention.</p> <p><strong>Methods:</strong> WRAP was a non-blinded, parallel-group randomised controlled trial (RCT). We recruited from primary care practices in England and randomly assigned participants to one of three interventions (brief intervention, 12-week open-group behavioural programme [WW, formerly Weight Watchers], or a 52-week open-group WW behavioural programme) in an uneven (2:5:5) allocation. Participants were followed up 5 years after randomisation using data from measurement visits at primary care practices or a research centre, review of primary care electronic medical notes, and self-report questionnaires. The primary outcome was change in weight at 5 years follow-up, assessed using analysis of covariance. We also estimated cost-effectiveness of the intervention. This study is registered at Current Controlled Trials, ISRCTN64986150.</p> <p><strong>Findings:</strong> Between Oct 18, 2012, and Feb 10, 2014, we recruited 1269 eligible participants (two participants were randomly assigned but not eligible and therefore excluded) and 1040 (82%) consented to be approached about additional follow-up and to have their medical notes reviewed at 5 years. The primary outcome (weight) was ascertained for 871 (69%) of 1267 eligible participants. Mean duration of follow-up was 5·1 (SD 0·3) years. Mean weight change from baseline to 5 years was −0·46 (SD 8·31) kg in the brief intervention group, −1·95 (9·55) kg in the 12-week programme group, and −2·67 (9·81) kg in the 52-week programme. The adjusted difference in weight change was –1·76 (95% CI –3·68 to 0·17) kg between the 52-week programme and the brief intervention; –0·80 (–2·13 to 0·54) kg between the 52-week and the 12-week programme; and –0·96 (–2·90 to 0·97) kg between the 12-week programme and the brief intervention. During the trial, the 12-week programme incurred the lowest cost and produced the highest quality-adjusted life-years (QALY). Simulations beyond 5 years suggested that the 52-week programme would deliver the highest QALYs at the lowest cost and would be the most cost-effective. No participants reported adverse events related to the intervention.</p> <p><strong>Interpretation:</strong> Although the difference in weight change between groups was not statistically significant, some weight loss was maintained at 5 years after an open-group behavioural weight management programme. Health economic modelling suggests that this could have important implications to reduce the incidence of weight-related disease and these interventions might be cost-saving.</p> |
| spellingShingle | Ahern, AL Breeze, P Fusco, F Sharp, SJ Islam, N Wheeler, GM Hill, AJ Hughes, CA Duschinsky, R Thomas, C Bates, S Woolston, J Stubbings, M Whittle, F Boothby, C Bostock, J Jebb, S Aveyard, P Boyland, E Halford, JCG Morris, S Brennan, A Griffin, SJ Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title | Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title_full | Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title_fullStr | Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title_full_unstemmed | Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title_short | Effectiveness and cost-effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity: 5-year follow-up of the WRAP randomised controlled trial |
| title_sort | effectiveness and cost effectiveness of referral to a commercial open group behavioural weight management programme in adults with overweight and obesity 5 year follow up of the wrap randomised controlled trial |
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