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Self-management interventions for adults living with obesity to improve patient-relevant outcomes: an evidence map.

Suñol, R., González-González, A.I., Valli, C., Ballester, M., Seils, L., Heijmans, M., Poortvliet, R., Gaag, M. van der, Rocha, C., León-Garcia, M., Salas-Gama, K., Niño de Guzmán, E., Kaloteraki, C., Santero, M., Spoiala, C., Gurung, P., Moaddine, S., Wilemen, F., Cools, I., Bleeker, J., Kancheva, A., Ertl, J., Laure, T., Kancheva, I., Veroniki, A.A., Zevgiti, S., Beltran, J., Canelo-Aybar, C., Zafra-Tanaka, J.H., Seitidis, G., Mavridis, D., Groene, O., Alonso-Coello, P., Orrego, C. Self-management interventions for adults living with obesity to improve patient-relevant outcomes: an evidence map. Patient Education and Counseling: 2023, 110, p. Art. nr. 107647.
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Objectives
To conduct an evidence map on self-management interventions and patient-relevant outcomes for adults living with overweight/obesity.

Methods
Following Arksey and O'Malley methodology, we searched in five electronical databases including randomized controlled trials (RCTs) on SMIs for overweight/obesity. We used the terms "self-management", "adult" and "obesity" for content. Two independent reviewers assessed eligible references; one reviewer extracted data, a second checked accuracy.

Results
We identified 497 RCTs (58% US, 20% Europe) including 99,741 (median 112, range 11-5145) adults living with overweight/obesity. Most research evaluated clinical outcomes (617, 55%) and behaviors adherence (255, 23%). Empowerment skills, quality of life and satisfaction were less targeted (8%, 7%, 0.2%, respectively). The most frequent techniques included sharing information (858, 99%), goal setting (619, 72%) and self-monitoring training (614, 71%), provided face-to-face (386, 45%) or in combination with remote techniques (256, 30%). Emotional management, social support and shared-decision were less frequent (18%, 26%, 4%). Socio-economic status, minorities or health literacy were seldom reported.

Conclusion
There is a need of widening the scope of research by focusing on outcomes important to patients, assessing emotional/social/share-decision support, exploring remote techniques and including vulnerable populations.