Introduction
General practitioners (GPs) need support and structured tools to assist them in managing patients with obesity. This six month implementation pilot based on Normalisation Process Theory aimed to assess the feasibility and acceptability of a weight management program (The Change Program) delivered by GPs within primary care.
Methods
The pilot study consisted of a single arm trial based on Normalisation Process Theory. GPs (n=12) across five practices (four urban, one rural) were recruited via email and then recruited their own patients (n=23). GPs were interviewed at time zero and 6 months and patients were interviewed at the end of the pilot. In addition, patients completed online surveys at time zero, 3 months and 6 months. Anthropometric data was collected using a file-based template.
Findings
Qualitative data analysis identified that GPs appreciated the structure of The Change Program and found it differed significantly from their usual consultation practices. They reported a significant increase in their confidence in managing obesity. Integration within daily practice would require activation of practice management systems to make the program sustainable. Patients found that establishing a constructive, collaborative working relationship with their GP was fundamental to their ongoing involvement in the program as well as meeting their weight loss and lifestyle change goals. Intention-to-treat analysis demonstrated that patients lost an average of 3.2% (SD 3.7, median 1.8%) of their body weight at 6 months with a range from -3.2% to 10.5%. Patients also provided feedback for improving The Change Program patient handbook.
Conclusion
This pilot study demonstrated that a GP-led weight management program is feasible and acceptable to GPs and their patients and suggested that a key determinant of success was to build on the values of person-centred primary healthcare. The positive results of this pilot confirm that a trial to assess overall effectiveness is needed.