PADRAIC 1,2 and 3 are a suite of systematic review and meta-analyses completed by 3 MSc students at the University of Manchester. They aim to synthesise current literature on the effectiveness, adherence and attrition of weight loss intervention.
PADRAIC 1
Background:
Excess adiposity, commonly approximated as body mass index is associated with at least 13 cancer types. Also studies shown that obesity is now the second commonest cause of cancer, after smoking, in many western countries. Therefore, how to control weight or weight loss, what interventions to use, and for what participants the interventions are most efficient have gradually become the focus of research.
Methods:
Prior to the conclusion of data collection and the beginning of statistical analysis, PROSPERO registered and reviewed the project methodology. CRD42022350653 is the registration number. This study will investigate the associations between weight loss and the following variables: mean age, baseline BMI, education level, gender, co-morbidities, and race (for example, using metan in Stata).
Results:
Data from forty trials in the literature were used for the analysis, younger and also older age (30-45&>55), male, lower BMI (30-35), lower education, and diabetic patients would get higher relative weight loss in the intervention while younger age (30-45), male, higher BMI (35-40), higher education, and diabetic patients would get better relative weight loss in the control group during follow-up.
Conclusion：
The trial successfully analyzed the effects of participant gender, age, baseline BMI, education level, and the presence of diabetes on the effectiveness of weight loss interventions, and although opposite results were obtained in the intervention and control groups when studying baseline BMI and education level, the study is still informative.
PADRAIC 2
Introduction:
Overweight and obesity are global health challenges associated with an increased risk of at least 13 adult obesity-related cancers. Thus, information on trial uptake, adherence and attrition rates will help inform the design of long-term, large-scale intervention trials studying the effect on cancer risk reduction. This systematic review aimed to analyse the uptake, adherence and attrition in behavioural weight management interventions and the impact of commonly reported demographics on them.
Methods:
A bibliographic search was conducted in Cochrane CENTRAL and Ovid Medline, and some studies were identified from a previous systematic review. The “metaprop” and “metan” in STATA were used to conduct meta-analyses and subgroup analyses for uptake, adherence and attrition. PROSPERO database (registration number ID:CRD42022350393)
Results:
Forty randomised controlled trials examining weight management interventions in European adults were included. The meta-analysis showed that the pooled estimated trial uptake, eligible trial uptake, and adherence were 45.5%, 88%, and 72%, respectively. The attritions at 3, 6, 12, 18 and 24 months suggested that the long-term intervention trials for obesity (over five years) may be practical, provided the sample size is sufficiently large. Subgroup analysis indicated that a relatively high number of patients with diabetes was associated with increased uptake. In contrast, a relatively high number of patients at high risk of diabetes was associated with low uptake. Also, the younger age was found to be associated with higher attrition. In addition, although the female population had higher trial acceptance and adherence to the weight management intervention, there may be no gender inequalities in attrition. The future long- term weight management intervention trial needs appropriately adjust the gender proportion or design gender-specific interventions to ensure male participants are represented.
PADRAIC 3
Background
In collaboration with the NIHR Nutrition & Cancer Collaborative and the Leeds Clinical Trials Unit (a CTRU with specific interests in complex trial interventions), we are developing a platform of sets of quantifiable information to construct simulations and pilot trials to test the effectiveness of weight management and cancer prevention.
Methods
Data were from previous studies included in the Shi lancet review to assess the difference in percentage weight loss between the use of drug + lifestyle and placebo + lifestyle weight management. The main outcome was a meta-analysis using a random effects model to show the percentage of weight loss in the intervention group (drug + lifestyle weight management) during the 1-1.5-year follow-up, the percentage of weight loss in the control group (placebo + lifestyle weight management) during the 1-1.5-year follow-up, and the difference between the intervention group and the control group in the percentage of weight loss before and after the follow-up. Additional results describe the proportion of people who lost more than 5% and 10% of their weight in the intervention and control groups. The meta-analysis shows the proportion of people who withdrew due to adverse events between the intervention and control groups.
Results
Involving 36 studies, 21332 participants were recruited. Compared with lifestyle improvement and placebo, the drug treatment group has a significant lead in weight loss (7%, 95% CI: – 0.08, 0.106), and the drug treatment group also has a more significant advantage in the proportion of people whose loss is greater than 5% and 10% of their weight. Participants who used lifestyle + placebo(5% of total) had a smaller proportion of withdrawal due to adverse reactions(lifestyle + drugs: 9% of total).
Conclusion
It can be predicted that the use of drugs + lifestyle for weight management can improve the weight loss effect. Although it has a higher adverse reaction withdrawal rate than placebo + lifestyle for weight management, its weight loss effect is far better than placebo + lifestyle. It is a treatment method worth considering. Although the effect of weight management with placebo + lifestyle is not very significant, the proportion of people who quit due to adverse reactions is less than that with drug + lifestyle. Pharmacological weight management is effective, but the risk of adverse reactions cannot be ignored. Appropriate weight management methods should be selected according to the patient’s physical condition
PADRAIC 