A Systematic Review of the Effectiveness of Lifestyle Modification on Metabolic Components and Patient Reported Outcomes in Adults with Metabolic Syndrome

Monday, 30 July 2012

Chia-Huei Lin, RN
Nursing department, Tri-Service General Hospital, Taipei, Taiwan
Li-Chi Chiang, RN, PhD
School of Nursing, School of Nursing, National Defense Medical Center, Taipei, Taiwan
Wen-Chii Tzeng, PhD
Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
Shang-Lin Chiang, MD
Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Tri-Service General Hospital, Taipei, Taiwan

Learning Objective 1: The learner will be able to know the effectiveness of lifestyle modification program on the metabolic components and patient reported outcomes (quality of life).

Learning Objective 2: The learner will be able to realize the nurses' independent role of how to implement the lifestyle modification program among adults with metabolic syndrome.

Objectives: This systematic review described lifestyle modification program on the risk components of metabolic syndrome (MetS) and patient reported outcomes among adults with MetS. Methods: We conducted a comprehensive and systematic literature search of multiple databases published from January 1985 to the first week of February 2011. The quality of included studies was assessed using the Cochrane criteria provided by the Cochrane collaboration. Results: Of the 4 randomized controlled trials that meet the inclusion criteria, only one used theoretical framework to guide intervention design. Three measured psychological outcomes (quality of life, self-efficacy, and perceived stress) as outcome indicators; the definition of MetS in most of studies (n=3) were based on NCEP-ATPⅢ. The most common applied components of intervention ranged from 4 to 24 weeks were: diet plans, supervised exercise, health monitoring, health education, individual counseling including behavioral modification, physical activity, motivational interviewing. The lifestyle modification programs for adults with MetS reduce various risk components (TG, WC, SBP), improve other physiological parameters (BW, BMI, HgbA1c, fitness level) and healthy behaviors in different trials. It seems longer duration of intervention (at least 3 months) has obvious improvements on patient reported outcomes especially on life quality. Conclusion: Although lifestyle modification programs have benefits on risk components of MetS and the patient reported outcomes, many limitations such as small sample size, high proportion of dropout, and heterogeneity among intervention designs exists. Future larger and rigorous RCTs need to assess the effectiveness of lifestyle modification program especially leading by nurses.