Quality standard
Quality statement 5: Weight loss
Quality statement 5: Weight loss
Quality statement
Adults with osteoarthritis who are living with overweight or obesity are offered support to lose weight.
Rationale
Weight loss is a core treatment for osteoarthritis that will improve joint pain and function. Adults with osteoarthritis who are living with overweight or obesity should be offered support to help them to lose weight, which may include weight management programmes tailored to their individual needs. It is important that support and encouragement to lose weight are ongoing and reinforced at every opportunity. Ongoing weight management support may be needed to ensure that a lower weight is maintained.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that adults with osteoarthritis who are living with overweight or obesity are offered support to lose weight.
Data source: Evidence can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from service specifications.
Process
Proportion of adults with osteoarthritis who are living with overweight or obesity who are offered support to lose weight.
Numerator – the number in the denominator who are offered support to lose weight.
Denominator – the number of adults with osteoarthritis who are living with overweight or obesity.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
Outcome
a) Weight loss in adults with osteoarthritis who are living with overweight or obesity.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
b) Patient satisfaction with support to lose weight.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient surveys.
What the quality statement means for different audiences
Service providers (GPs, community healthcare providers and hospitals) ensure that processes and referral pathways are in place so that adults with osteoarthritis who are living with overweight or obesity are offered support to lose weight.
Healthcare professionals ensure that they offer support to adults with osteoarthritis who are living with overweight or obesity to lose weight, such as referral to a weight management service.
Commissioners ensure that they commission services in which adults with osteoarthritis who are living with overweight or obesity are offered support to lose weight. Commissioners also ensure that there is sufficient capacity in weight management services to meet demand for adults with osteoarthritis.
Adults with osteoarthritis who are living with overweight or obesity are offered help to lose weight, which can improve symptoms, such as pain, as well as general health and wellbeing.
Source guidance
Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226 (2022), recommendations 1.2.2 and 1.3.5
Definitions of terms used in this quality statement
Overweight or obesity
Body mass index (BMI) is used as a practical estimate to identify overweight and obesity. For information on thresholds for overweight or obesity, see NICE's guideline on obesity: identification, assessment and management. [NICE's guideline on obesity: identification, assessment and management, recommendations 1.2.4, 1.2.5, 1.2.7 to 1.2.10, 1.2.21 and 1.2.24]
Support to lose weight
Support to help someone with osteoarthritis to lose weight should focus on multicomponent interventions, and may also include pharmacological and surgical interventions. The level of support should be determined by the person's symptoms and needs, and be responsive to changes over time. Weight management programmes should be delivered by a trained professional. They should include behaviour change strategies to increase physical activity and encourage healthy eating. [Adapted from NICE's guideline on obesity: identification, assessment and management, recommendations 1.2.12, 1.2.13, 1.2.15, 1.2.16, 1.2.28, 1.2.29, 1.4.1, 1.4.4, 1.8.6, 1.8.8, 1.10.1 and 1.10.2]
Equality and diversity considerations
Healthcare professionals should take into account cultural and communication needs (including any learning disabilities) when providing information and support for adults with osteoarthritis. This should include providing printed information for people who cannot access information online and providing information in accessible large print and easy read formats where needed. For adults with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard or the equivalent standards for the devolved nations.
When referring adults with osteoarthritis to a weight management service, any potential difficulties in accessing services, which may include distance, disability and financial obstacles, should be taken into account.