“Effects of the Croí CLANN structured lifestyle modification programme on anthropometric and

metabolic characteristics in severely obese adults”

Irene Gibson

Nurse Lead & Programmes Manager

Honorary Clinical Fellow NUI Galway

Background

•Six in 10 adults (18-64yrs) are either overweight or obese (NANS 2011)

•Almost 1 in 4, 7 year olds are overweight or obese (Childhood Obesity Surveillance Initiative, 2012).

•In the ROI the direct & indirect costs of overweight & obesity in 2009 were estimated at €1.13billion.(Safefood, 2013)

•Prevalence of diabetes expected to increase by 37% over next 10 years

•Prevalence of CVD expected to increase by 30% over next 10 years

Background

Background

Few studies have described the effects of structured lifestyle programmes specifically in bariatric patients

Lifestyle modification is fundamental to obesity treatment

Croí CLANN commenced in October 2010

Aim - to provide an efficient and effective multidisciplinary lifestyle intervention to patients who are currently waiting in excess of two years for assessment of their obesity.

• 10 week community based intensive-lifestyle programme• Led by a multidisciplinary team of Nurse Specialist, Dietitian,

Physiotherapist/Physical Activity Specialist• Referrals – Bariatric Medicine • Recruitment Criteria – bariatric

patients ≥18 years with a BMI ≥40 kg m2

• Outcome focused

What is Croí CLANN?

Individual Assessment

•Behaviour change strategy•Individual Goal Setting

•Education•Personal Record Card & Resource

Pack

Comprehensive Programme

•Patient attends for 2 hrs once per week•Individual review•Structured, minimal equipment exercise session•Health promotion sessions•Social support

Outcomes

•August 2012 –June 2013, 127 individuals were referred to the programme with a response rate of 80%

•Programme completion was high at 92%

•Males 38%, Female 62%,

•Mean age - 48.8 years, age range 24-72years

•33% of patients were from regions outside of Galway

Outcomes

Significant improvements in:•Weight, BMI, Waist Circumference•Lipids, •Physical fitness•Psychosocial health

No improvements observed in: Glucose & Hba1cBlood Pressure

.

Patients Feedback

“I was surprised at how much I enjoyed the exercises and have joined other Croi classes since completion”

“I learnt how to control my eating habits and for the first time realised the damage I was inflicting on myself”

“Felt completely at ease, non judgemental, learnt a lot and am using knowledge and tools I learnt”

“I had a fantastic time on the programme, I really enjoyed it, I changed my whole lifestyle of health eating and exercise”

Conclusion

•Demonstrates the effectiveness of applying an integrated care approach to the management of obesity •Complements the existing services available at GUH and is having a positive impact on reducing the bariatric service waiting list

•This programme is acceptable to obese patients.

•Offers a unique opportunity to formally assess the benefits and feasibility of this type of intervention on severely obese Irish adults -a randomised controlled trial is warranted.

Acknowledgements

HSE-funding the programme through a grant aid agreement

Croí Team - Jenni Jones, Claire Kerins, Caroline Costello, Katie Cunningham, Jane Windle

GUH- Dr. Francis Finucane & Helena Griffin

CLANN programme participants