Obesity management by general practitioners: the unavoidable necessity

2015 ◽  
Vol 21 (4) ◽  
pp. 366 ◽  
Author(s):  
Sarah Jansen ◽  
Ben Desbrow ◽  
Lauren Ball
Keyword(s):  
Primary Care ◽  
Weight Management ◽  
National Health ◽  
Public Health Issue ◽  
Management Support ◽  
Obesity Management ◽  
Management Interventions ◽  
Primary Care Patients ◽  
Insufficient Time

Nearly 62% of primary care patients are overweight or obese, and obesity is now a National Health Priority Area. Weight management interventions in primary care currently generate little more than 1 kg of weight loss per patient over a 2-year period. Consequently, further strategies are required to improve the effectiveness of weight management in primary care. The National Health and Medical Research Council (NHMRC) have released updated guidelines for the management of overweight and obese patients in primary care. However, there is some disconnect between establishment of guidelines and their implementation in practice. Barriers to GPs using guidelines for the management of obesity include low self-efficacy, perceived insufficient time in consultations and the challenge of raising the topic of a patient’s weight. Nonetheless, patients prefer to receive weight management support from GPs rather than other health professionals, suggesting that the demand on GPs to support patients in weight management will continue. GPs cannot afford to side-line obesity management, as obesity is likely to be the most prevalent modifiable risk factor associated with patients’ long-term health. Without further strategies to support GPs in their management of patients’ weight, obesity will continue to be an expensive and long-term public health issue.

scholarly journals Using a brief web-based 5A intervention to improve weight management in primary care: results of a cluster-randomized controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Franziska D. Welzel ◽  
Jonathan Bär ◽  
Janine Stein ◽  
Margrit Löbner ◽  
Alexander Pabst ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Management ◽  
Controlled Trial ◽  
Obesity Management ◽  
Online Tutorial ◽  
Low Threshold ◽  
Cluster Randomized

Abstract Background The primary health care setting is considered a major starting point in successful obesity management. However, research indicates insufficient quality of weight counseling in primary care. Aim of the present study was to implement and evaluate a 5A online tutorial aimed at improving weight management and provider-patient-interaction in primary health care. The online tutorial is a stand-alone low-threshold minimal e-health intervention for general practitioners based on the 5As guidance for obesity management by the Canadian Obesity Network. Methods In a cluster-randomized controlled trial, 50 primary care practices included 160 patients aged 18 to 60 years with obesity (BMI ≥ 30). The intervention practices had continuous access to the 5A online tutorial for the general practitioner. Patients of control practices were treated as usual. Primary outcome was the patients’ perspective of the doctor-patient-interaction regarding obesity management, assessed with the Patient Assessment of Chronic Illness Care before and after (6/12 months) the training. Treatment effects over time (intention-to-treat) were evaluated using mixed-effects linear regression models. Results More than half of the physicians (57%) wished for more training offers on obesity counseling. The 5A online tutorial was completed by 76% of the physicians in the intervention practices. Results of the mixed-effects regression analysis showed no treatment effect at 6 months and 12 months’ follow-up for the PACIC 5A sum score. Patients with obesity in the intervention group scored lower on self-stigma and readiness for weight management compared to participants in the control group at 6 months’ follow-up. However, there were no significant group differences for weight, quality of life, readiness to engage in weight management, self-stigma and depression at 12 months’ follow-up. Conclusion To our knowledge, the present study provides the first long-term results for a 5A-based intervention in the context of the German primary care setting. The results suggest that a stand-alone low-threshold minimal e-health intervention for general practitioners does not improve weight management in the long term. To improve weight management in primary care, more comprehensive strategies are needed. However, due to recruitment difficulties the final sample was smaller than intended. This may have contributed to the null results. Trial registration The study has been registered at the German Clinical Trials Register (Identifier: DRKS00009241, Registered 3 February 2016).

scholarly journals Complementary and Integrative Health Approaches for Weight Management in the Obese Population: The 2018 Korea National Health and Nutrition Examination Survey

2021 ◽  
Vol 18 (15) ◽  
pp. 8161
Author(s):  
Sang-Dol Kim
Keyword(s):  
Food Intake ◽  
Weight Management ◽  
National Health ◽  
Age Group ◽  
Nutrition Examination Survey ◽  
Obesity Management ◽  
Health And Nutrition ◽  
Obese Population ◽  
Nationally Representative ◽  
Management Approaches

(1) Background: Obesity management has become an important issue due to the COVID-19 outbreak; therefore, periodic surveys on the approaches to obesity management of the entire population and target obese population are required. (2) Methods: The study used nationally representative data from the 2018 Korea National Health and Nutrition Examination Survey. Participants reported all approaches they had used to reduce or maintain weight in the past year. Data were analyzed with multiple response methods. (3) Results: The most commonly reported approach was exercise, which included fitness, yoga, biking, and other physical activities (74.7% of respondents), and the second most commonly reported approach was decreased food intake (69.6% of respondents). The use of approaches differed according to respondents’ demographic characteristics. Regarding sex-related differences, in particular, men preferred to exercise, while women were more likely to decrease food intake. Among men, exercise was highest in the 40–49 years age group (48.3%). Among women, decreased food intake was highest in the same age group (16.1%). (4) Conclusions: These findings indicate that it is necessary to introduce individualized weight management approaches and measures according to target groups in obese adults.

scholarly journals Informing the development of online weight management interventions: a qualitative investigation of primary care patient perceptions

BMC Obesity ◽  
2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Samantha B. van Beurden ◽  
Sally I. Simmons ◽  
Jason C. H. Tang ◽  
Avril J. Mewse ◽  
Charles Abraham ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Management ◽  
Primary Care Patient ◽  
Care Patient ◽  
Patient Perceptions ◽  
Qualitative Investigation ◽  
Management Interventions

scholarly journals Long-Term Weight-Loss Maintenance by a Meal Replacement Based Weight Management Program in Primary Care

Obesity Facts ◽  
2017 ◽  
Vol 10 (2) ◽  
pp. 76-84 ◽  
Author(s):  
Renate Kruschitz ◽  
Sandra Wallner-Liebmann ◽  
Harald Lothaller ◽  
Maria Luger ◽  
Bernhard Ludvik
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Weight Management ◽  
Weight Loss Maintenance ◽  
Management Program ◽  
Weight Management Program ◽  
Meal Replacement

scholarly journals Patient experience on self-management support among primary care patients with diabetes and hypertension

2019 ◽  
Vol 31 (7) ◽  
pp. 37-43 ◽  
Author(s):  
Ming Tsuey Lim ◽  
Yvonne Mei Fong Lim ◽  
Xin Rou Teh ◽  
Yi Lin Lee ◽  
Siti Aminah Ismail ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Experience ◽  
Educational Level ◽  
Linear Regression Analysis ◽  
Self Management ◽  
Short Version ◽  
Design Decision ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Primary Care Patients

Abstract Objective To determine the extent of self-management support (SMS) provided to primary care patients with type 2 diabetes (T2D) and hypertension and its associated factors. Design Cross-sectional survey conducted between April and May 2017. Setting Forty public clinics in Malaysia. Participants A total of 956 adult patients with T2D and/or hypertension were interviewed. Main Outcome Measures Patient experience on SMS was evaluated using a structured questionnaire of the short version Patient Assessment of Chronic Illness Care instrument, PACIC-M11. Linear regression analysis adjusting for complex survey design was used to determine the association of patient and clinic factors with PACIC-M11 scores. Results The overall PACIC-M11 mean was 2.3(SD,0.8) out of maximum of 5. The subscales’ mean scores were lowest for patient activation (2.1(SD,1.1)) and highest for delivery system design/decision support (2.9(SD,0.9)). Overall PACIC-M11 score was associated with age, educational level and ethnicity. Higher overall PACIC-M11 ratings was observed with increasing difference between actual and expected consultation duration [β = 0.01; 95% CI (0.001, 0.03)]. Better scores were also observed among patients who would recommend the clinic to friends and family [β = 0.19; 95% CI (0.03, 0.36)], when health providers were able to explain things in ways that were easy to understand [β = 0.34; 95% CI (0.10, 0.59)] and knew about patients’ living conditions [β = 0.31; 95% CI (0.15, 0.47)]. Conclusions Our findings indicated patients received low levels of SMS. PACIC-M11 ratings were associated with age, ethnicity, educational level, difference between actual and expected consultation length, willingness to recommend the clinic and provider communication skills.

scholarly journals GP-delivered brief weight loss interventions: a cohort study of patient responses and subsequent actions, using conversation analysis in UK primary care

2018 ◽  
Vol 68 (674) ◽  
pp. e646-e653 ◽  
Author(s):  
Charlotte Albury ◽  
Elizabeth Stokoe ◽  
Sue Ziebland ◽  
Helena Webb ◽  
Paul Aveyard
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Cohort Study ◽  
Conversation Analysis ◽  
Weight Management ◽  
Management Service ◽  
Management Interventions ◽  
Weight Management Programme ◽  
Patient Responses ◽  
Weight Loss Interventions

BackgroundGuidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.AimTo examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and settingA mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.MethodConversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.ResultsAffirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.ConclusionWhen doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.

scholarly journals Evaluation of the 13-item Hypomania Checklist and a brief 3-item manic features questionnaire in primary care

2017 ◽  
Vol 41 (4) ◽  
pp. 187-191 ◽  
Author(s):  
Sukhmeet Singh ◽  
Paul Scouller ◽  
Daniel J. Smith
Keyword(s):  
Primary Care ◽  
Bipolar Disorder ◽  
Clinical Implications ◽  
Predictive Values ◽  
Mean Delay ◽  
Item Questionnaire ◽  
Primary Care Patients ◽  
The Mean ◽  
Recorded Diagnosis

Aims and methodThe mean delay for bipolar disorder diagnosis is 10 years. Identification of patients with previous hypomania is challenging, sometimes resulting in misdiagnosis. The aims of this study were: (a) to estimate the proportion of primary care patients with depression currently taking antidepressants who have undiagnosed bipolar disorder and (b) to compare a brief 3-item manic features questionnaire with the Hypomania Checklist (HCL-13). The sample comprised patients with a recorded diagnosis of depression, either on long-term antidepressant therapy or with previous multiple courses of antidepressants.ResultsOf 149 participants assessed, 24 (16.1%) satisfied criteria for bipolar disorder. Areas under the curve (AUC) for the 3-item questionnaire and the HCL-13 were similar (0.79 and 0.72, respectively) but positive predictive values (PPV) were low.Clinical implicationsBipolar disorder may be underdiagnosed in primary care. A 3-item questionnaire could be used by general practitioners to screen for bipolar disorder in their patients with depression.

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