The reflux improvement and monitoring (TRIM) program is associated with symptom improvement and weight reduction for patients with obesity and gastroesophageal reflux disease

Rena Yadlapati*, John E. Pandolfi, Olga Alexeeva, Dyanna L. Gregory, Meredith R. Craven, David Liebovitz, Abbey Lichten, Erin Seger, Moira Workman, Nora St Peter, Jenna Craft, Bethany Doerfler, Rajesh N. Keswani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

OBJECTIVES: Current healthcare systems do not effectively promote weight reduction in patients with obesity and gastroesophageal refl ux disease (GERD). The Refl ux Improvement and Monitoring (TRIM) program provides personalized, multidisciplinary, health education and monitoring over 6 months. In this study we aimed to (i) measure the effectiveness of TRIM on GERD symptoms, quality of life, and weight, and (ii) examine patient health beliefs related to TRIM. METHODS: This prospective mixed methods feasibility study was performed at a single center between September 2015 and February 2017, and included adult patients with GERD and a body mass index .30 kg/m2 . Quantitative analysis consisted of a pre-to post-intervention analysis of TRIM participants (+TRIM Cohort) and a multivariable longitudinal mixed model analysis of +TRIM vs. patients who declined TRIM (.TRIM Cohort). Primary outcomes were change in patient-reported GERD symptom severity (GerdQ) and quality of life (GerdQ-DI), and change in percent excess body weight (%EBW). Qualitative analysis was based on two focus groups of TRIM participants. RESULTS: Among the +TRIM cohort ( n =52), mean baseline GerdQ scores (8.7±2.9) decreased at 3 months (7.52.2; P <0.01) and 6 months (±1.9; P =0.02). Mean GerdQ-DI scores decreased, but did not reach statistical signifi cance. Compared with the .TRIM cohort ( n =89), reduction in %EBW was signifi cantly greater at 3, 6, and 12 months among the +TRIM cohort ( n =52). In qualitative analysis, patients unanimously appreciated the multidisciplinary approach and utilized weight loss effectively to improve GERD symptoms. CONCLUSIONS: In this mixed methods feasibility study, participation in TRIM was associated with symptom improvement, weight reduction, and patient engagement.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume113
Issue number1
DOIs
StatePublished - 2018

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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