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Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic.

Most SW, Højgaard B, Teilmann G, Andersen J, Valentiner M, Gamborg M, Holm JC - BMC Pediatr (2015)

Bottom Line: Risk of dropout was independent of baseline characteristics.Median time spent by health care professionals was 4.5 hours per year per patient and the mean visit interval time was 2.7 months.The reductions in BMI SDS were dependent on gender, parental BMI, and family structure in girls, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time.

View Article: PubMed Central - PubMed

Affiliation: The Children's Obesity Clinic, Department of Pediatrics, Nordsjællands Hospital, Hillerød, Copenhagen University, Dyrehavevej 29, DK-3400, Hillerød, Denmark. sebastian.most@gmail.com.

ABSTRACT

Background: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol.

Methods: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th percentile for sex and age were eligible for inclusion. At baseline patients' height, weight, and tanner stages were measured, as well as parents' socioeconomic status (SES) and family structure. Parental weight and height were self-reported. An individualised treatment plan including numerous advices was developed in collaboration with the patient and the family. Patients' height and weight were measured at subsequent visits. There were no exclusion criteria.

Results: Three-hundred-thirteen (141 boys) were seen in the clinic in the period of February 2010 to March 2013. At inclusion, the median age of patients was 11.1 years and the median BMI standard deviation score (SDS) was 3.24 in boys and 2.85 in girls. After 1 year of treatment, the mean BMI SDS difference was -0.30 (95% CI: -0.39; -0.21, p < 0.0001) in boys and -0.19 (95% CI: -0.25; -0.13, p < 0.0001) in girls. After 2 years of treatment, the mean BMI SDS difference was -0.40 (95% CI: -0.56; -0.25, p < 0.0001) in boys and -0.24 (95% CI: -0.33; -0.15, p < 0.0001) in girls. During intervention 120 patients stopped treatment. Retention rates were 0.76 (95% CI: 0.71; 0.81) after one year and 0.57 (95% CI: 0.51; 0.63) after two years of treatment. Risk of dropout was independent of baseline characteristics. Median time spent by health care professionals was 4.5 hours per year per patient and the mean visit interval time was 2.7 months. The reductions in BMI SDS were dependent on gender, parental BMI, and family structure in girls, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time.

Conclusions: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time-investment by health professionals.

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Related in: MedlinePlus

Kaplan-Meier plot illustrating the rate of dropouts. An estimated retention function. Rate of drop-outs during treatment.
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Fig2: Kaplan-Meier plot illustrating the rate of dropouts. An estimated retention function. Rate of drop-outs during treatment.

Mentions: During intervention 120 patients stopped treatment: 60 (50%) due to families not showing up to appointments: 42 (35%) requested to stop, 16 (13%) stopped because they achieved success, and 2 (2%) dropped out for other reasons. Figure 2 shows the dropout analysis. Retention rates were 0.76 (95% CI: 0.71; 0.81) after one year of treatment, and 0.57 (95% CI: 0.51; 0.63) after two years of treatment. No significant associations between baseline characteristics and retention rates were found. No significant associations were observed between BMI SDS changes during treatment and drop-outs. See Table 3 for hazard ratios.Figure 2


Adoption of the children's obesity clinic's treatment (TCOCT) protocol into another Danish pediatric obesity treatment clinic.

Most SW, Højgaard B, Teilmann G, Andersen J, Valentiner M, Gamborg M, Holm JC - BMC Pediatr (2015)

Kaplan-Meier plot illustrating the rate of dropouts. An estimated retention function. Rate of drop-outs during treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4363201&req=5

Fig2: Kaplan-Meier plot illustrating the rate of dropouts. An estimated retention function. Rate of drop-outs during treatment.
Mentions: During intervention 120 patients stopped treatment: 60 (50%) due to families not showing up to appointments: 42 (35%) requested to stop, 16 (13%) stopped because they achieved success, and 2 (2%) dropped out for other reasons. Figure 2 shows the dropout analysis. Retention rates were 0.76 (95% CI: 0.71; 0.81) after one year of treatment, and 0.57 (95% CI: 0.51; 0.63) after two years of treatment. No significant associations between baseline characteristics and retention rates were found. No significant associations were observed between BMI SDS changes during treatment and drop-outs. See Table 3 for hazard ratios.Figure 2

Bottom Line: Risk of dropout was independent of baseline characteristics.Median time spent by health care professionals was 4.5 hours per year per patient and the mean visit interval time was 2.7 months.The reductions in BMI SDS were dependent on gender, parental BMI, and family structure in girls, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time.

View Article: PubMed Central - PubMed

Affiliation: The Children's Obesity Clinic, Department of Pediatrics, Nordsjællands Hospital, Hillerød, Copenhagen University, Dyrehavevej 29, DK-3400, Hillerød, Denmark. sebastian.most@gmail.com.

ABSTRACT

Background: Treating severe childhood obesity has proven difficult with inconsistent treatment results. This study reports the results of the implementation of a childhood obesity chronic care treatment protocol.

Methods: Patients aged 5 to 18 years with a body mass index (BMI) above the 99th percentile for sex and age were eligible for inclusion. At baseline patients' height, weight, and tanner stages were measured, as well as parents' socioeconomic status (SES) and family structure. Parental weight and height were self-reported. An individualised treatment plan including numerous advices was developed in collaboration with the patient and the family. Patients' height and weight were measured at subsequent visits. There were no exclusion criteria.

Results: Three-hundred-thirteen (141 boys) were seen in the clinic in the period of February 2010 to March 2013. At inclusion, the median age of patients was 11.1 years and the median BMI standard deviation score (SDS) was 3.24 in boys and 2.85 in girls. After 1 year of treatment, the mean BMI SDS difference was -0.30 (95% CI: -0.39; -0.21, p < 0.0001) in boys and -0.19 (95% CI: -0.25; -0.13, p < 0.0001) in girls. After 2 years of treatment, the mean BMI SDS difference was -0.40 (95% CI: -0.56; -0.25, p < 0.0001) in boys and -0.24 (95% CI: -0.33; -0.15, p < 0.0001) in girls. During intervention 120 patients stopped treatment. Retention rates were 0.76 (95% CI: 0.71; 0.81) after one year and 0.57 (95% CI: 0.51; 0.63) after two years of treatment. Risk of dropout was independent of baseline characteristics. Median time spent by health care professionals was 4.5 hours per year per patient and the mean visit interval time was 2.7 months. The reductions in BMI SDS were dependent on gender, parental BMI, and family structure in girls, but independent of baseline BMI SDS, age, co-morbidity, SES, pubertal stage, place of referral, hours of treatment per year, and mean visit interval time.

Conclusions: The systematic use of the TCOCT protocol reduced the degree of childhood obesity with acceptable retention rates with a modest time-investment by health professionals.

Show MeSH
Related in: MedlinePlus