Given that guideline-directed obesity treatment is imperative in the primary care setting, this multimethod study aimed to assess its presence via a prospective clinician survey and retrospective patient data analysis. Twenty seven primary care clinicians completed the survey, reporting general agreement with guideline-directed obesity treatment and demonstrating gaps in knowledge of evidence-based practices. >2900 baseline and follow-up patient care encounters were analyzed, revealing a lack of positive clinical outcomes and appropriate anti-obesity medication prescribing patterns.
Abstract
Introduction
Effective, evidence-based obesity treatment is needed, which often involves use of anti-obesity medications (AOMs). Data on the breadth and quality of guideline-directed obesity treatment implementation in primary care remain limited. This study aimed to assess primary care clinicians’ agreement with and knowledge of guideline-directed obesity treatment, as well as to assess the health status of persons with obesity and their use of AOMs.
Methods
This multimethod study included a prospective survey of primary care clinicians, utilizing a questionnaire that measured agreement on a 5-point Likert scale and knowledge via multiple choice questions. A retrospective analysis was also performed of patient data collected between 30 June 2016 and 30 June 2020 from primary care clinics in the Midwest.
Results
Data were analyzed from 27 clinician survey responders, finding agreement toward all measured areas, however less strong for chronic AOM use and resource allocation. The survey identified multiple gaps in knowledge. Researchers assessed 5656 baseline encounters and 2941 corresponding follow-up encounters. Analysis revealed ≥50% of the total patients experienced persistently uncontrolled obesity (mean body mass index of ≥40 kg/m2) and weight-related complications. Low rates (≤10%) of AOM use in clinically eligible patients were shown, with phentermine monotherapy being the most commonly used.
Conclusions
Clinicians agree with guideline-directed obesity treatment. Persons with obesity who are poorly controlled identify an opportunity for patient care improvement.