One strong quality 3-arm randomised controlled trial(3) examined the effectiveness of an in-person or a web-based self-management program compared to a control receiving printed educational materials.
The program was designed to improve patients’ weight management skills by enhancing selfmanagement and self-efficacy and helping them overcome barriers to success. It included education on healthful eating, physical activity, behavioural modification techniques, and dealing with stress and maladaptive eating behaviours. It was delivered as thirteen group education sessions to the inperson group and thirteen online modules to the web-based group
The evidence of effectiveness for self-management programs to support lifestyle and health behaviour change in patients awaiting bariatric surgery is lacking for the following outcomes:
Proportion of patients achieving 5% weight loss:
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Biomarkers of metabolic health (% weight change, absolute weight change, BMI, blood pressure and serum parameters- blood glucose, Glycosylated haemoglobin HbA1c, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides):
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Depression:
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Health-related quality of life:
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Readiness to change:
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Self-efficacy:
Might not be effective (One strong quality study showing no effect for either intervention compared to control)(3).
Cost effectiveness:
Relative to the control arm, the per-patient incremental cost was $278 for the in-person strategy and $274 for the web-based strategy. Total incremental annual costs were $474,546 for the in-person strategy and $7,188 for the web-based strategy(3).
The study was conducted in Canada(3). Therefore, generalisability to the Welsh context should be considered.
The intervention took place in adults with morbid obesity waiting for bariatric surgery(3), and therefore may not be applicable to patients waiting for other types of elective surgeries.
It is suggested that further robust research and thorough evaluation of impact is needed.