TRIM promotes symptom improvement, weight loss in patients with GERD, obesity
The Reflux Improvement and Monitoring (TRIM) programme for the management of patients with obesity and gastroesophageal reflux disease (GERD) appears to produce improvements in patient-reported symptom severity, quality of life and weight, a study reports.
Providing personalized health education and goal setting to patients, TRIM is a 6-month intervention consisting of an initial consultation, followed by three weekly follow-up sessions and then five monthly sessions with an educator. During follow-up sessions, the educators reviewed change in weight, dietary and exercise goals, reinforced education, and provided resources as needed. Patient-reported weights and GerdQ responses were recorded at each follow-up session.
In the study, a total of 52 GERD patients (mean age 54.4 years; 77 percent female; median BMI, 34.3 kg/m2) were enrolled in the TRIM programme. All patients were on single- or double-dose proton pump inhibitor. Primary outcomes of interest were change in patient-reported GERD symptom severity (GerdQ) and quality of life (GerdQ-DI), and change in percent excess body weight (%EBW).
Results showed that mean baseline GerdQ scores dropped from 8.7 to 7.5 at 3 months (p<0.01) and to 7.4 at 6 months (p=0.02). On the other hand, while the mean GerdQ-DI scores declined, the change did not reach statistical significance.
Compared with those who did not undergo the TRIM programme (n=89), patients in the TRIM programme had greater reductions in %EBW at 3, 6 and 12 months. In qualitative analysis, patients unanimously appreciated the multidisciplinary approach and utilized weight loss effectively to improve GERD symptoms.
The present data underscore the potential of TRIM in the management of GERD and obesity, researchers said, adding that the strengths of the intervention include optimized electronic health record functionality, minimal interference with clinician workflow, multidisciplinary care coordination and a patient-centred approach.
“Lifestyle management programmes tailored to patients with obesity and with GERD, such as TRIM, should be integrated into health promotion practices,” they added.