OBJECTIVE
To evaluate the effectiveness of organizational models and digital remote monitoring and support for reducing excess body weight in primary healthcare.
MATERIAL AND METHODS
A multiple-center (5 constituent entities of the Russian Federation) randomized study involved men and women aged 18—60 years with body mass index (BMI) 27—37 kg/m2. All ones underwent prevention of chronic non-infectious diseases in organizational models of primary health care (health center, medical prevention department of a territorial polyclinic, paramedic and midwifery station). All patients received individual in-depth preventive counseling at primary visit. We used the Doctor PM mobile application preinstalled on personal smartphones for control and remote support. The follow-up period was 6 months.
RESULTS
After 6 months, patients of all organizational models significantly (p<0.001) decreased body weight, BMI and waist circumference compared to baseline values (p>0.05). At the same time, target body weight (5% decrease from baseline value) was significantly more common in patients of health centers (46.7%) and paramedic midwifery station (45.1%) compared to medical prevention department of a territorial polyclinic (23.9%, p<0.05). In all organizational models, consumption of foods with excess fat and simple carbohydrates significantly decreased, and physical activity (number of daily steps) increased. Patients of health centers were characterized by higher physical activity throughout the first 5 months of follow-up (p<0.05).
CONCLUSION
Individual in-depth preventive counseling followed by remote monitoring ensures decrease in anthropometric indicators regardless of organizational model. However, achievement of target weight loss was significantly more common in health centers and paramedic midwifery stations compared to medical prevention department of territorial clinics. Modifying dietary habits and higher physical activity are important predictors regardless of organizational model.
