Access to weight reduction interventions for overweight and obese patients in UK primary care: population-based cohort study.

Abstract

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/m(2) 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 antiobesity 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 4099 (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 antiobesity drugs 89.9 (95% CI 85.0 to 95.2). Weight management interventions were more often accessed by women, older patients, those with comorbidity 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.

• Authors: Helen P Booth, A Toby Prevost, Martin C Gulliford
• Journal: BMJ open (BMJ Open) Vol. 5 Issue 1 Pg. e006642 (Jan 13 2015) ISSN: 2044-6055 [Electronic] England
• PMID: 25586371 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Anti-Obesity Agents

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Obesity Agents (therapeutic use)
• Body Mass Index
• Cohort Studies
• Counseling (statistics & numerical data)
• Electronic Health Records
• Exercise
• Female
• Health Services Accessibility (statistics & numerical data)
• Humans
• Life Style
• Male
• Middle Aged
• Obesity (therapy)
• Overweight (therapy)
• Primary Health Care (statistics & numerical data)
• Referral and Consultation (statistics & numerical data)
• United Kingdom