Category: Obesity/Nutrition

Monitor: 5

5 - The Weight of the Matter: Medical Residents Attitudes and Knowledge towards Weight Screening and Management Introduction

Friday, Apr 26
12:00 PM – 12:30 PM

Objective :

Obesity is among the most serious medical conditions least addressed during inpatient and outpatient office visits. The United States Preventive Services Task Force (USPSTF) recommends screening all adults greater than 18 years of age for obesity. 


Methods : We reviewed the medical charts of all adults with a BMI ≥ 30 kg/ m2 seen in our clinic from May 1, 2018 through June 30, 2018. We recorded the total number of problems addressed, type of visit, whether obesity was addressed and the resources utilized by the residents and attendings for management. From July 1st, 2018 through December 31st, 2018, residents were educated on obesity screening and management tools. Residents were educated through lectures and conferences. Posters were placed in the clinic and all physicians were encouraged to schedule separate visits to discuss obesity. Following this education initiative, data was then collected from Jan 1st, 2019 to febuarary 28th, 2019.


Results :

This study included 556 patients (pre resident education = 301 and post = 255). Homogeneity between pre and post groups was found on age category (chi-sq(4)= 3.661, P =.454), sex (FET, P = .861), and visit type (chi-sq(2) = 3.345, P =.188). The independent samples Mann-Whitney U test revealed patient characteristics of body mass index (BMI), number of comorbidities, and number of diagnoses addressed during the appointment also to be homogenous (P = .637, .165, .376, respectively). The study sample had a mean age group of 40 – 50 years, was 61% female, and 91% of the office visits were for follow-up. The average BMI was 38. Patients had an average of 2 comorbidities and residents most often addressed five diagnoses. From pre to post, a statistically significant improvement (22% increase) in the frequency at which health maintenance was addressed with the patient was found (62% vs 83%, chi-sq(1) = 31.764, P < .0005). The dramatic 52% improvement (17% to 69%) in addressing obesity (lifestyle modification, medication management, or bariatric surgical intervention) was also revealed to be statistically significant (chi-sq(1 ) = 157.096, P


Discussion :

Despite the challenges of lack of awareness of resources for obesity management, time limitation and multiple other comorbid conditions, our study suggests that residents can effectively use quality improvement (QI) methods to improve patient care in residency clinics.


Conclusion : We recommend employing QI methodology to improve awareness among physicians and residents regarding obesity screening and management; doing so may eventually result in better overall health if the obesity rate declines with a subsequent reduction in obesity related comorbid conditions

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Hassan Mehmood

Resident
Temple University/Conemaugh Memorial Medical
Johnstown, Pennsylvania

Resident Physician

Ali Hussain

Resident Physician
Temple/ Conemaugh MMC, Pennsylvania

Resident Physician

Salah Aldergash

Physician
Temple/ Conemaugh MMC, Pennsylvania

Associate Program Director

Asghar Marwat