Background: General practitioners encounter many barriers when addressing obesity in primary care. Shared medical appointments (SMAs) are increasing in popularity and may help mitigate some of these barriers.
Aims: Primary aims were to measure the effect of weight loss SMAs on initial and sustained weight loss. Secondary aims were to explore patient engagement with weight loss SMAs including participant characteristics (e.g., socioeconomic status, gender), response rates, attrition and cost.
Methods: Systematic searches were conducted in the CENTRAL, Medline Complete, PsycINFO, Scopus, CINAHL, EMBASE and Web of Science databases in March 2021. Studies reporting on weight loss SMAs for adults and children in primary care were included. Risk of bias was assessed using the Effective Health Practice Project Quality Assessment Tool for Quantitative Studies. Meta-analysis of controlled studies was planned.
Results: Fifteen studies involving weight loss SMAs in adults (n=10) and children (n=5) were identified. All but one included study was assessed as being weak in quality and six studies had controls. Inconsistency in reporting weight loss and/or weight change in controlled studies meant that data could not be pooled for meta-analysis. There was also a high level of heterogeneity in the design and delivery of weight loss SMAs (e.g., duration, number of SMAs in program). Results from individual studies indicated that SMAs can support adult patients to achieve significant weight loss. Females and older adults were more likely to take up SMA invitations. Results from studies involving children were less conclusive. Despite the purported cost advantages of SMAs, for patients and the health system, only four studies reported on the cost of weight loss SMAs.
Discussion: Weight loss SMAs can facilitate weight loss in adults. Well designed, prospective and controlled studies are required to assess whether weight loss SMAs are superior to other weight loss options in primary care.