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SHINE: Telephone intervention boosted weight loss for patients with metabolic syndrome

Issue: August 2012

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PHILADELPHIA — Results of the SHINE study demonstrate that primary care staff can be trained to deliver a Diabetes Prevention Program intervention by telephone in individual and group formats to help patients with metabolic syndrome achieve significant weight loss.

Ruth S. Weinstock, MD, PhD, presented 6-month and 1-year outcomes from the Support, Health Information, Nutrition and Exercise (SHINE) study. The researchers randomly assigned 257 patients with metabolic syndrome and no diabetes at five diverse primary care practices in upstate New York to two telephone interventions based on the Diabetes Prevention Program (DPP). Trained primary staff delivered the intervention to patients on an individual basis (n=129) or in a group conference call with a minimum of eight participants (n=128). The 16-session DPP curriculum was delivered over 1 year by trained staff, with continued contact in year 2, according to the abstract.

The patients’ mean age was 51 years; mean BMI was 39; and mean waist circumference was 118 cm.

At 6 months, mean weight loss was 4.1 kg among patients assigned solo intervention and 4.6 kg among patients assigned group intervention. Waist circumference decreased by 3.4 cm after solo intervention and 5.1 cm after group intervention. Similar trends were observed at 1 year, with 4.8-kg weight loss and 2.7-cm waist circumference change in the solo intervention arm and 6-kg weight loss and 6-cm waist circumference change in the group intervention arm (P<.01 for all). BMI decreased by 2 kg/m² in both arms.

The researchers examined the data based on completer status, defined as patients who participated in at least nine of the 16 DPP phone intervention sessions. Completers had even greater weight loss at 1 year — 7.1 kg — and greater weight loss overall, Weinstock said.

The study also focused on the percentage of patients who achieved weight loss goals at 1 year. In the intention-to-treat analysis, 40% of patients and 50% of completers lost at least 5% of their initial body weight. Thirty-one percent of patients and 42% of completers lost at least 7% of their body weight, according to the abstract.

“Telephone DPP intervention is feasible and can be effective,” Weinstock, of Upstate University Hospital, State University of New York, said. “Group telephone intervention is as effective as individual telephone intervention.” – by Katie Kalvaitis