246075 Assessment and management of adult obesity in an ambulatory primary care practice

Tuesday, November 1, 2011: 11:10 AM

Sherry Adkins, MD, MPH , Center for Global Health Systems, Management & Policy, Wright State University, Kettering, OH
Marietta Orlowski, PhD , Department of Health, Physical Education and Recreation, Wright State University, Dayton, OH
Sylvia Ellison, MA , Center for Global Health Systems, Management, and Policy, Wright State University, Boonshoft School of Medicine, Kettering, OH
Purpose: The purpose of this project was to describe primary care physician adherence to National Heart Lung and Blood Institute (NHLBI) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998), and to explore patient characteristics associated with physician assessment and management behaviors. Patient characteristics included age, sex, race, BMI, associated disease risk, and Medicaid coverage. Methods: A chart abstraction of 100 randomly selected adult patients with at least one visit to a particular hospital-affiliated primary care practice during a 12-month period was completed. Patients were not pregnant during the year of review, and had a Body Mass Index of 25 or greater. The Physician Obesity Guideline Behavior Scale was developed and validated to score physician obesity assessment and management behavior as recorded in the patient chart. Results: Only 25% of clinically overweight or obese adult patients had actually been diagnosed as such. All patients had a weight/height recorded in the chart and 60% included a BMI. The majority of patients did not receive any dietary (72%) or physical activity (69%) management. When dietary management was introduced, those patients received either information (68%) or a goal (32%), and none received a goal with an accompanying plan. In cases where physical activity management was introduced, patients received a goal (52%) or information (39%), with few (10%) receiving a goal with accompanying plan. Preliminary findings suggest that physician assessment and management behaviors vary by patient characteristics.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
1. Describe primary care physician assessment and management behaviors related to adult obesity. 2. Identify the components of the NHLBI Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults. 3. List patient characteristics association with physician assessment and management of adult obesity.

Keywords: Physicians, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the research assistant on this project and collected all data and participated in the data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.