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

doi:10.1038/ajg.2017.262

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 journal › Article › peer-review

14 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 language	English (US)
Pages (from-to)	23-30
Number of pages	8
Journal	American Journal of Gastroenterology
Volume	113
Issue number	1
DOIs	https://doi.org/10.1038/ajg.2017.262
State	Published - 2018

Funding

Guarantor of the article: Rena Yadlapati, MD, MSHS Specific author contributions: R.Y.: study oversight, study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.E.P.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; O.A.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.G.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.R.C.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.: study concept and design, critical revision of the manuscript for important intellectual content, and finalization of manuscript; A.L.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; E.S.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.W.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; N.S.P.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.C.: study concept and design, acquisition of data, analysis and interpretation of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; B.D.: study concept and design, critical revision of the manuscript for important intellectual content; and finalization of manuscript; R.N.K.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript. Financial support: R.Y. was supported by NIH T32DK101363. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Potential competing interests: None.

ASJC Scopus subject areas

Gastroenterology
Hepatology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/ajg.2017.262

Cite this

Yadlapati, R., Pandolfi, J. E., Alexeeva, O., Gregory, D. L., Craven, M. R., Liebovitz, D., Lichten, A., Seger, E., Workman, M., St Peter, N., Craft, J., Doerfler, B., & Keswani, R. N. (2018). The reflux improvement and monitoring (TRIM) program is associated with symptom improvement and weight reduction for patients with obesity and gastroesophageal reflux disease. American Journal of Gastroenterology, 113(1), 23-30. https://doi.org/10.1038/ajg.2017.262

@article{4ab8226929f942059ca1696ddb7fa8ec,

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

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.",

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

note = "Funding Information: Guarantor of the article: Rena Yadlapati, MD, MSHS Specific author contributions: R.Y.: study oversight, study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.E.P.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; O.A.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.G.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.R.C.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.: study concept and design, critical revision of the manuscript for important intellectual content, and finalization of manuscript; A.L.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; E.S.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.W.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; N.S.P.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.C.: study concept and design, acquisition of data, analysis and interpretation of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; B.D.: study concept and design, critical revision of the manuscript for important intellectual content; and finalization of manuscript; R.N.K.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript. Financial support: R.Y. was supported by NIH T32DK101363. Research reported in this publication was supported, in part, by the National Institutes of Health{\textquoteright}s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Potential competing interests: None. Publisher Copyright: {\textcopyright} 2018 by the American College of Gastroenterology.",

year = "2018",

doi = "10.1038/ajg.2017.262",

language = "English (US)",

volume = "113",

pages = "23--30",

journal = "American Journal of Gastroenterology",

issn = "0002-9270",

publisher = "Wolters Kluwer Health",

number = "1",

}

Yadlapati, R, Pandolfi, JE, Alexeeva, O, Gregory, DL, Craven, MR, Liebovitz, D, Lichten, A, Seger, E, Workman, M, St Peter, N, Craft, J, Doerfler, B & Keswani, RN 2018, 'The reflux improvement and monitoring (TRIM) program is associated with symptom improvement and weight reduction for patients with obesity and gastroesophageal reflux disease', American Journal of Gastroenterology, vol. 113, no. 1, pp. 23-30. https://doi.org/10.1038/ajg.2017.262

The reflux improvement and monitoring (TRIM) program is associated with symptom improvement and weight reduction for patients with obesity and gastroesophageal reflux disease. / Yadlapati, Rena; Pandolfi, John E.; Alexeeva, Olga et al.
In: American Journal of Gastroenterology, Vol. 113, No. 1, 2018, p. 23-30.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The reflux improvement and monitoring (TRIM) program is associated with symptom improvement and weight reduction for patients with obesity and gastroesophageal reflux disease

AU - Yadlapati, Rena

AU - Pandolfi, John E.

AU - Alexeeva, Olga

AU - Gregory, Dyanna L.

AU - Craven, Meredith R.

AU - Liebovitz, David

AU - Lichten, Abbey

AU - Seger, Erin

AU - Workman, Moira

AU - St Peter, Nora

AU - Craft, Jenna

AU - Doerfler, Bethany

AU - Keswani, Rajesh N.

N1 - Funding Information: Guarantor of the article: Rena Yadlapati, MD, MSHS Specific author contributions: R.Y.: study oversight, study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.E.P.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; O.A.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.G.: study concept and design, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.R.C.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript; D.L.: study concept and design, critical revision of the manuscript for important intellectual content, and finalization of manuscript; A.L.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; E.S.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; M.W.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; N.S.P.: study concept and design, acquisition of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; J.C.: study concept and design, acquisition of data, analysis and interpretation of data, critical revision of the manuscript for important intellectual content, and finalization of manuscript; B.D.: study concept and design, critical revision of the manuscript for important intellectual content; and finalization of manuscript; R.N.K.: study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, critical revision of the manuscript for important intellectual content, and finalization of manuscript. Financial support: R.Y. was supported by NIH T32DK101363. Research reported in this publication was supported, in part, by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Potential competing interests: None. Publisher Copyright: © 2018 by the American College of Gastroenterology.

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

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U2 - 10.1038/ajg.2017.262

DO - 10.1038/ajg.2017.262

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SN - 0002-9270

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EP - 30

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

IS - 1

ER -

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

Abstract

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ASJC Scopus subject areas

UN SDGs

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