Summary: Obesity and overweight are significant public health problems, worldwide. Hence, there is the importance of developing and applying strategies that reduce weight in this population. We set out to evaluate the effectiveness of obesity intervention with three different approaches—one of them with a platform that promotes physical activity. 

Methods: Randomized, controlled, parallel clinical trial that compared three arms, multicenter study in overweight or obese patients, with a 12-month follow-up. The patients were randomized into three groups: Intervention in the primary care center with intervention G1: Control group, which received the usual recommendations of losing weight following the SEEDO 2000 (Sociedad Española para el Estudio de la Obesidad) Consensus, G2: Motivational intervention of obesity (IMOAP) with a trained nurse and small periodic work groups, and G3: IMOAP adding the use of a digital platform to record physical activity, monitors it, and, in turn, favors the practice of this (aka iwopi: the concept that physical activity has a positive impact beyond the activity). Variables collected included: weight, height, body mass index (BMI), waist circumference, lipid parameters, blood pressure, and glycosylated hemoglobin. After the interventions, clinical relevance indicators were studied. Relative risk (RR), absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT), both for intention to treat and for biological efficacy. 

Results: Cholesterol levels in three groups were reduced. The BMI showed a general average reduction. Total cholesterol levels were reduced in all groups, with the largest decrease in G3. Triglyceride levels were significantly reduced in two groups. Glycosylated hemoglobin showed a slight decrease that did not reach a statistically significant value.

Conclusions: The digital health platform that stimulates physical activity added to an interventionist motivation in patients with overweight or obesity is a significant additional benefit in terms of weight loss results, BMI reduction, and lipid profile in patients affected by overweight or obesity, and a most effective cost.

Background: Patients affected by the COVID-19 pandemic required physical/social isolation due to the transmissibility of SARs CoV-2; those hospitalized in healthcare facilities often suffered loneliness due to a complete separation from their loved ones through visitor restrictions.(1) Human contact and movement were restricted to contain the spread of disease. When this kind of restriction must be employed, the “Guidance for Managing Ethical Issues in Infectious Disease Outbreaks”, states that it is necessary to provide people with “effective alternative communication strategies”. (2) Methods:  This is an observational descriptive study that uses qualitative variables to analyze information obtained by virtual focus groups consisting of either medical professionals or family members of hospitalized patients in the ICU of the Eugenio Espejo Hospital (EEH) in Quito, Ecuador. Each video call allowed us to assess anonymous opinions concerning communication methods utilized during the delivery of daily clinical updates in the ICU. By focusing on a patient-and family-centered model, this study aims to minimize the impact of social isolation in hospitalized patients through the implementation of regular doctor-led video conference calls with family members, as well as video calls between the patient and family members when feasible.(1) Results: This study evaluates the increased satisfaction of family members and medical professionals with the implementation of video calls when compared to traditional telephone calls. A contrast between the time before implementing the telehealth team and the time afterward was observed in at least five positive characteristics: 1) the general telehealth experience, 2) the clarity of the messages, 3) the quality of care, 4) the sense of comfort, and 5) the improvement of communication. Conclusions: There was a positive effect on communication quality for both family members and medical professionals, increasing their satisfaction in terms of finding new methods to reduce the social isolation enforced by the current pandemic. Nevertheless, the future role of virtual communication remains undefined as we return to individualized face-to-face meetings.  

Dr. Bailey discusses the evolving role physicians play in healthcare related to policy and technology including telehealth and remote care.

Biography

Dr. Bailey is a distinguished allergist/immunologist from Fort Worth, Texas, is immediate past president of the American Medical Association. A fierce advocate for physician autonomy and private practice, Dr. Bailey has held numerous leadership positions with the AMA and has also represented the AMA on the Accreditation Council for Continuing Medical Education, the American Board of Medical Specialties, and COLA. Dr. Bailey has been an allergist in private practice for over 30 years and completed her residency in general pediatrics and a fellowship in allergy/immunology at the Mayo Graduate School of Medicine in Rochester, Minnesota. She has been awarded the title of Distinguished Fellow of the American College of Allergy, Asthma, and Immunology. Dr. Bailey was later appointed to the Texas A& M System Board of Regents by then-Gov. George W. Bush, and has been named a Distinguished Alumnus of Texas A&M University and of Texas A&M University College of Medicine.