Effectiveness of general practitioner-delivered nutrition care on dietary and health outcomes in adults with chronic conditions: a systematic review
Notice bibliographique
Résumé
OBJECTIVES: To evaluate the effectiveness of nutrition care delivered by general practitioners (GPs) compared with usual or no care on dietary and health outcomes in adults with diet-related chronic conditions or risk states and to examine which intervention components are associated with effectiveness. STUDY DESIGN: A systematic review of randomised controlled trials (RCTs). DATA SOURCES: CINAHL, Embase, MEDLINE and ProQuest Nursing and Allied Health databases were searched in October 2021 and updated in February 2024 for articles related to GPs, nutrition care and diet-related health outcomes. ELIGIBILITY CRITERIA: Published RCTs were included according to the following criteria: adults with or at risk of diet-related chronic conditions; nutrition care delivered by GPs in the primary care setting; usual or no care as comparators; and dietary and/or health outcomes with a minimum 3-month follow-up. No restriction was placed on the date of publication. DATA EXTRACTION AND SYNTHESIS: Duplicates were reconciled in EndNote. Two reviewers independently screened the titles, abstracts and full texts in Covidence. Two independent reviewers completed the critical appraisal and data extraction. Disagreements were resolved through discussion or with a third reviewer. The Motivation Actions and Prompts (MAP) framework was used to analyse the behaviour change components of study interventions. Results were reported using narrative synthesis and certainty in findings was summarised using GRADEpro GDT software. RESULTS: Seven RCTs met the inclusion criteria (5744 patients). The trials were conducted in Australia, Italy and the USA from 1991 to 2013, with follow-up periods from 3 to 12 months. A consistent effect in favour of the intervention was found for diet scores (2 RCTs, 3038 participants). Other outcomes had mixed effects: (1) fat intake (2 RCTs, 2299 participants) - one study with an effect in favour of the intervention and one with mixed effects; (2) blood pressure (3 RCTs, 3063 participants) - one study with mixed effects and two with no effect; (3) body mass index (6 RCTs, 5538 participants) - two studies with an effect in favour of the intervention, two with no effect and two reporting no between group differences; (4) body weight (2 RCTs, 511 participants) - one study with an effect in favour of the intervention and one with no effect and (5) cholesterol (4 RCTs, 2505 participants) - one study with an effect in favour of the intervention and three with mixed effects and/or limited reporting. All studies had a motivation and action route to behaviour change and two had a prompted component, according to the MAP framework. The interventions spanned nine behaviour change groupings and 16 behaviour change techniques. There was a very low certainty of findings in all cases and the studies were of low to moderate methodological quality. CONCLUSIONS: There is mixed evidence of the effectiveness of GP-delivered nutrition care among adults with diet-related chronic conditions or risk states. Additionally, most interventions did not include prompting and had a limited range of behaviour change techniques. The effectiveness of nutrition care delivered by GPs is an understudied area that warrants greater experimental investigation and requires more robust methods and reporting. PROSPERO REGISTRATION NUMBER: CRD42021289011.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,021 | 0,084 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,010 |
| Bibliométrie | 0,006 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».