Oral Presentation Australian & New Zealand Obesity Society 2014 Annual Scientific Meeting

Feasibility, effectiveness, and cost-effectiveness of a telephone-based weight loss program delivered via a hospital outpatient setting  (#11)

Megan Whelan 1 , Ana D Goode 1 , Elizabeth G Eakin 1 , Lennert J Veerman 2 , Elisabeth AH Winkler 1 , Ingrid J Hickman 3 4 , Marina M Reeves 1
  1. Cancer Prevention Research Centre, School of Population Health, The University of Queensland, Brisbane, QLD, Australia
  2. School of Population Health, The University of Queensland, Brisbane
  3. Mater Medical Research Institute, Brisbane
  4. Nutrition and Dietetics Department, Princess Alexandra Hospital, Brisbane

Background: Engaging patients in a group-based weight loss program is a challenge for the acute-care hospital outpatient setting. Aim: To evaluate a telephone-based weight loss service as an alternative to an existing face-to-face, group-based service in terms of reach, effectiveness and cost-effectiveness. Methods: Two-group pre-post design feasibility study. Patients who declined a 2-month group-based program were offered a 6-month telephone program. Outcomes (primary effectiveness outcome = objectively measured weight) were assessed at baseline, 2-months, and 6-months (telephone only). Changes within the telephone program were analysed by paired t-tests. Differences between the programs at 2-months were compared with linear regression models, adjusting for baseline values and confounders. The cost per healthy life year gained was calculated for both programs. Results: Fifty patients (19% of referrals) commenced the group-based program (60% female, 57.4 ± 13.5 years [mean ± SD]), with 66% completion at 2-months. Sixty-one patients (44% of eligible) commenced the telephone program (46% female; 49.3 ± 12.0 years), with 57% completion at 6-months. The telephone program achieved significant weight loss (-4.1 ± 5.0% body weight, p<0.05) at 6-months. Compared to the group-based program, the telephone program was associated with greater weight loss (mean difference [95%CI]: -2.0 [-3.4,-0.6] % body weight change; p=0.007) at 2-months. The cost per healthy life year gained was $33,000 and $85,000, for the telephone and group-based programs, respectively. Conclusions: The telephone-delivered weight management service was cost-effective, more effective for weight loss than usual (group-based) care, and reached participants who declined usual care. Exploring such alternative and broad-reaching service delivery models is important for the significant proportion of patients who remain unengaged with existing weight management services.