January 17, 2012

JHM collaborates with Healthways on weight-loss program

Initiative designed to replicate success of recent clinical trial

Building on the success of recent Johns Hopkins research showing that obese participants were able to lose significant weight and keep it off for two years using telephone coaching and a specially designed website, Johns Hopkins Medicine is collaborating with Healthways to help bring the innovative weight-loss program to many more who could benefit from it.

Johns Hopkins and Healthways, a global health and well-being improvement company, have developed Innergy, a commercially available version of the call center–directed weight-loss program pioneered and studied by Lawrence J. Appel, a professor of medicine at the Johns Hopkins University School of Medicine. The results of the study were published in November in the New England Journal of Medicine. Under the agreement between the two parties, Johns Hopkins will advise Healthways on the design and implementation of Innergy, continuously evaluate the program and oversee future enhancements. In addition, several Johns Hopkins faculty members will serve on Innergy’s scientific advisory board.

Healthways will be responsible for the sale and delivery of Innergy to physicians and health systems, employers, health plans and governments.

Healthways is a provider of specialized programs to help people maintain or improve their health and well-being and, as a result, reduce overall health care costs.

“This collaboration with Healthways reflects our commitment to providing health solutions to the marketplace that are solidly based on the best science,” said Patricia M.C. Brown, president of Johns Hopkins HealthCare, the managed care and population health arm of Johns Hopkins Medicine. “Through our participation, we will be advancing the objectives of Johns Hopkins Medicine to foster intellectual discovery, develop innovative care delivery models and improve human health.”

Obesity is an important and growing public health problem in the United States, where one in three adults is obese and thus at increased risk of mortality, especially from cardiovascular disease. Obesity by some estimates costs the United States more than $250 billion a year in health care and lost productivity costs, and is rising by $50 billion per year.

In the POWER (Practice-Based Opportunities for Weight Reduction) trial, Appel and his colleagues found that roughly 40 percent of obese patients enrolled in the telephone-based weight-loss program lost at least 5 percent of their body weight, an amount associated with real health benefits, such as lower blood pressure, lower cholesterol and better diabetes control. Participants received weekly phone calls from health coaches for three months and then monthly thereafter. They also were encouraged to regularly sign in to an interactive website with tools to track weight and provide regular feedback by email. Another arm of the trial used in-person instead of telephone coaching, with similar results.

As part of the POWER trial, Healthways developed the data collection and intervention websites, provided the lifestyle coaches who delivered the intervention over the phone and provided unrestricted funds in support of the trial.

“In most weight-loss studies, there is a lot of emphasis on frequent, in-person counseling sessions, but from a logistical perspective, in-person interventions are challenging for both patients and counselors,” Appel said. “Patients start off strong but then stop attending in-person sessions. The telephonic coaching and Web-based program, on the other hand, is convenient to individuals and can be done anywhere. Obesity is a major national public health problem, and Hopkins’ expertise in this program can hopefully have a tremendous positive impact on this growing problem.”

Frederick L. Brancati, a professor of medicine and chief of the division of General Internal Medicine at the Johns Hopkins University School of Medicine, says that the findings of the POWER trial are exciting because they show a practical way to keep the weight off for a long period of time.

“Most other studies show maximal effect at six months, but few demonstrate maintenance over one year, let alone two years, as in POWER,” said Brancati, who was involved in the trial. “Our objective now is to share this proven tool with thousands more who struggle with their weight. Historically, the translation of population health science to practice can take many years to accomplish. With this collaboration, we will quickly be able to make this intervention available to large numbers of people who can benefit.”

Commenting on the collaboration and its objective, Ben Leedle, president and CEO of the Tennessee-based Healthways, said, “We believe that Innergy now offers a proven solution to the obesity challenge, particularly given the recent decision of the Centers for Medicare and Medicaid Services to provide reimbursement for physician-directed weight-management counseling services. We are pleased to be able to offer this scientifically validated program to so many more people who can benefit from it.”

Johns Hopkins receives financial compensation from Healthways in the form of royalties and fees for its contribution to the Innergy program.