Primary Care & Weight Reduction Interventions: A Happy Marriage?

Research Paper Title

Access to Weight Reduction Interventions for Overweight and Obese Patients in UK Primary Care: Population-based Cohort Study.

Objectives

To investigate access to weight management interventions for overweight and obese patients in primary care.

Setting

UK primary care electronic health records.

Participants

A cohort of 91,413 overweight and obese patients aged 30-100 years was sampled from the Clinical Practice Research Datalink (CPRD). Patients with body mass index (BMI) values ≥25 kg/m2 recorded between 2005 and 2012 were included. BMI values were categorised using WHO criteria.

Interventions

Interventions for body weight management, including advice, referrals and prescription of anti-obesity drugs, were evaluated.

Primary and secondary outcome measures

The rate of body weight management interventions and time to intervention were the main outcomes.

Results

Data were analysed for 91,413 patients, mean age 56 years, including 55,094 (60%) overweight and 36,319 (40%) obese, including 4,099 (5%) with morbid obesity.

During the study period, 90% of overweight patients had no weight management intervention recorded. Intervention was more frequent among obese patients, but 59% of patients with morbid obesity had no intervention recorded. Rates of intervention increased with BMI category. In morbid obesity, rates of intervention per 1000 patient years were:

  • Advice: 60.2 (95% CI 51.8 to 70.4);
  • Referral: 75.7 (95% CI 69.5 to 82.6); and
  • Anti-obesity drugs: 89.9 (95% CI 85.0 to 95.2).

Weight management interventions were more often accessed by women, older patients, those with co-morbidity and those in deprivation. Follow-up of body weight subsequent to interventions was infrequent.

Conclusions

Limited evidence of weight management interventions in primary care electronic health records may result from poor recording of advice given, but may indicate a lack of patient access to appropriate body weight management interventions in primary care.

Reference

Booth, H.P., Prevost, A.T. & Gulliford, M.C. (2015) Access to Weight Reduction Interventions for Overweight and Obese Patients in UK Primary Care: Population-based Cohort Study. BMJ Open 2015;5:e006642. doi:10.1136/bmjopen-2014-006642

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