E038 Towards better support with weight management for rheumatology patients taking glucocorticoids: a scoping review of brief interventions

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Abstract Background/Aims Weight gain is a major concern for patients taking glucocorticoids for their chronic rheumatic diseases, and obesity worsens disease outcomes. These patients desire more support with their weight management. Brief opportunistic interventions used within consultations may be beneficial to promote behaviour changes. The aim of this scoping review was to map peer-reviewed evidence regarding the use of brief interventions to support weight management either in, or applicable to, rheumatology settings. Methods We followed the JBI methodology, conducting a comprehensive search of MEDLINE, Embase and APA PsychINFO from inception to October 2024. We included qualitative and quantitative studies, extracting and summarising the characteristics of the studies, participants and brief interventions. Results Forty-one studies were included in this review. Of these, there were 25 primary studies exploring 22 different brief interventions. The commonest approaches used were verbal advice and paper-based handouts. There was no direct evidence related to the use of brief interventions within rheumatology settings. Of 22 studies reporting setting, 19 took place in primary care or the community. One study discussed the development of future education materials for patients with psoriatic arthritis. None of the studies explored the prevention of weight gain. Many studies included overweight or obese participants only, with outcomes focusing on weight loss rather than maintenance of a healthy weight. Quantitative outcomes assessed in the study included the frequency of brief intervention use and its effects on weight and weight-related risk factors. Qualitative findings focused on exploring the language used in weight-related discussions, the feasibility of brief interventions, and clinician and patient views. These findings suggested that, whilst clinicians are concerned about causing offence, patients considered brief interventions to be appropriate and welcomed these discussions. Barriers to implementing brief interventions included time constraints, stigma and resource practicalities. Conversely, facilitators to implementing brief interventions were their short duration, the availability of guidelines and the existence of long-term doctor-patient relationships. Conclusion Whilst this review highlighted a paucity of research into brief intervention use in rheumatology settings, evidence from other healthcare settings could be transferable. Due to the high visit frequency in rheumatology, it is likely that these long-term relationships between clinicians and patients could act as a facilitator for the use of brief interventions. There remains significant scope to investigate brief interventions for weight loss and the prevention of weight gain in rheumatology patients taking long-term glucocorticoids. Disclosure H.E. Speight: None. J. Leonardi-Bee: None. J.C. Robson: Grants/research support; JCR received a Steroid PRO research start-up grant from Above & Beyond Bristol Hospitals Charity; Steroid PRO research grant from Vifor Pharma; GCA PRO funding from NIHR Research for Patient Benefit, she also received a Steroid PRO cross-condition validation study research grant from Sanofi. F.A. Pearce: Grants/research support; FAP is funded by a National Institute for Health and Care Research Advanced Fellowship [grant number NIHR300863], FAP is also the recipient of a grant from Vifor pharma. Vifor pharma had no influence on the design, conduct or interpretation of this study. S.J. Lax: Grants/research support; SJL is funded by a National Institute for Health and Care Research Advanced Fellowship [grant number NIHR300863].

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