Telemedical coaching for weight loss in overweight employees: a three-armed randomised controlled trial

Abstract

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 3-6 and monthly calls from months 7 to 12. C2 had a short coaching phase in months 6-9. 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 [5.5-10.3 kg], all p<0.01) and sustained it during the 36 months follow-up (-4.8 to -7.8 kg [5.6-12.8 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.

Keywords: preventive medicine; public health; telemedicine.

Conflict of interest statement

Competing interests: KK and SM received research support from Boehringer Ingelheim International GmbH & Co. KG. MS is an employee of Boehringer Ingelheim Pharma GmbH & Co. KG. SM is a member of the Boehringer Ingelheim Pharma GmbH & Co. KG advisory board. No other potential conflicts of interest relevant to this article are existent. The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1

Flow diagram. TMC, telemedical coaching.

Figure 2

Flowchart for the design of the study. At baseline, the TMC-group and C1-group were equipped with telemonitoring devices (scales and pedometers), and the C2-group 6 months later as well. TMC-group was coached with weekly care calls in months 3–6 and monthly calls from month 7 to 12. C2-group had only a short coaching phase with care calls in months 6–9. TMC, telemedical coaching.

Figure 3

Reduction of body weight. (A) Differences in weight changes between groups were analysed using χ2 test (*p<0.05). (B) Differences of weight loss between all groups were analysed using Kruskal-Wallis test with Dunn’s multiple comparisons test (*p<0.05; **p<0.01; ****p<0.0001). TM, telemedical; TMC, telemedical coaching.