Obese patients’ compliance and satisfaction with educational intervention: O.N.E. packet


Department of Family Medicine, Center for Urban Population Health, Aurora UW Medical Group

Presentation Notes

Presented at 2014 Aurora Scientific Day, Milwaukee, WI


Background: Today, 36% of U.S. adults are obese. Combating obesity is important, as obesity has been shown to increase risk of hypertension, dyslipidemia and type 2 diabetes. The obesity rate in the state of Wisconsin in 2010 was 26%. It is well established that physician counseling is effective in promoting healthy behavior. Although weight loss is asked and advised during clinic visits, physicians rarely assess, assist or arrange interventions.

Purpose: To determine if distribution of educational materials to patients with body mass index (BMI) > 30 kg/m2 affects lifestyle modification compliance; and to determine if there is a difference in compliance between physician distribution or peer educator personal summary of educational materials. Methods: Adults with BMI > 30 kg/m2 were randomized before the clinic visits into one of two groups using preprinted envelopes. Physician group patients were handed the packet by the resident physicians. Patient educator group had brief visits with the patient educator who summarized the information and answered questions. Follow-up phone calls were made to patients using a standardized questionnaire. Chi-square or Fisher exact tests were used for categorical data, Mann-Whitney tests for age/BMI; binary logistic regression was used for multivariate analysis.

Results: Of the 180 patients eligible to participate, 165 patients were enrolled in the study (80 patient educator, 85 physician) and 15 lost to follow-up. Mean age was 42 ± 14, 76% were female, 81% were African American, and mean visit BMI was 37 ± 7. When asked if they remembered who gave them the packet (patient educator vs. physician), 74% of patients responded correctly. Of the patients who made diet or lifestyle changes since receiving the packet, 68% (54) were from patient educator and 45% (38) from physician (P=0.003). The most common changes were: exercised more (24%, 39), ate healthier (33%, 54), and more aware of what I ate (35%, 57). Visit BMI was not associated with lifestyle change (P=0.07). Univariate analysis determined younger age (35 vs. 50, P=0.0012), brief patient educator visits (P=0.005) and accurate recall of who distributed information (P=0.000) were associated with patient reported lifestyle changes, confirmed by multivariate regression (P=0.03, P=0.007 and P=0.001, respectively).

Conclusion: Younger age, brief patient educator visits, and accurate recall of the educational event were significantly associated with patient-reported lifestyle changes in obese patients.

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