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Telemedical coaching for weight loss in overweight employees: a three-armed randomised controlled trial [with consumer summary]
Kempf K, Rohling M, Martin S, Schneider M
BMJ Open 2019 Apr;9(4):e022242
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: We examined the effect of a telemedical coaching (TMC) programme accompanied with or without telemonitoring on weight loss in an occupational healthcare setting with a three-armed randomised controlled trial (NCT01837134 'pre-results'). METHODS: Overweight employees (n = 104, body mass index (BMI) >= 25 kg/m2) were invited by their medical corporate department and randomised into either a TMC group (n = 34) or in one of the two control groups (C1, n = 34; C2, n = 36). TMC and C1 were equipped with telemonitoring devices (scales and pedometers) at baseline, and C2 after 6 months. Telemonitoring devices automatically transferred data into a personalised online portal. TMC was coached with weekly care calls in months 3 to 6 and monthly calls from months 7 to 12. C2 had a short coaching phase in months 6 to 9. C1 received no further support. After the 12-month intervention phase, participants could take advantage of further company health promotion offers. Follow-up data were determined after 12 months of intervention and per-protocol (PP) and intention-to-treat (ITT) analyses were performed. Weight change was followed up after 36 months. Estimated treatment difference (ETD) was calculated for weight reduction. RESULTS: ETD from TMC to C1 (-3.6 kg 95% CI -7.40 to -0.1, p = 0.047) and to C2 (-4.2 kg (-7.90 to -0.5), p = 0.026) was significantly different at the 12 months follow-up in the PP-analysis, but lost significance in the ITT analysis. All groups reduced weight after 12 months (-3.3 to -8.4 kg (5.5 to 10.3 kg), all p < 0.01) and sustained it during the 36 months follow-up (-4.8 to -7.8 kg (5.6 to 12.8 kg), all p < 0.01). ETD analyses revealed no difference between all groups neither in the PP nor in the ITT analysis at the 3 years follow-up. All groups reduced BMI, systolic and diastolic blood pressure and improved eating behaviour in the PP or ITT analyses. CONCLUSIONS: TMC and/or telemonitoring support long-term weight reduction in overweight employees. The combination of both interventions points towards an additional effect. TRIAL REGISTRATION NUMBER: NCT01837134.
Reproduced with permission from the BMJ Publishing Group.

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