Effect of implementing the 5As of Obesity Management framework on provider-patient interactions in primary care
Effect of implementing the 5As of Obesity Management framework on provider-patient interactions in primary care
复制标题
DOI：
10.1111/cob.12038
复制
发表时间：
2014-02-01
期刊：
影响因子：
3.3
通讯作者：
Sharma, A. M.
中科院分区：
文献类型：
--
作者：
Rueda-Clausen, C. F.;Benterud, E.;Sharma, A. M.
肥胖症在初级保健中仍然管理不善。肥胖管理的5a是一个理论驱动的，以证据为基础的最小干预，旨在促进初级保健从业者的肥胖咨询和管理。该项目测试了在初级保健诊所实施该工具的影响。在四家初级保健诊所（超过25家医疗保健提供者[HCPs]）预约结束时，预先筛选的肥胖受试者完成了电子自我管理调查。这些测量在实施肥胖管理5a之前（基线，n = 51）和实施后1个月（干预后，n = 51）进行。干预措施包括一个在线培训课程（90分钟），并向参与诊所的HCPs分发5As工具包。在干预前后完成调查的受试者在年龄、性别、体重指数、合并症、满意度和自我报告的健康状况方面具有可比性（P < 0.05）。实施肥胖管理5a导致肥胖管理的启动率增加了两倍（19比39%，P = 0.03），并导致感知随访/协调努力的统计学显著增加（自我报告的慢性疾病护理患者评估，45 +/- 22比67 +/- 12分，P = 0.002），以及5a框架的两个组成部分：评估（50 +/- 29比66 +/- 15分，P = 0.03）和辅助（54 +/- 26比72 +/- 13分，P = 0.01）。我们的研究结果表明，通过促进医患沟通、肥胖医学评估和后续护理计划，使用肥胖管理的5a有助于初级保健中的体重管理。
Obesity remains poorly managed in primary care. The 5As of Obesity Management is a theory-driven, evidence-based minimal intervention designed to facilitate obesity counselling and management by primary care practitioners. This project tested the impact of implementing this tool in primary care clinics. Electronic self-administered surveys were completed by pre-screened obese subjects at the end of their appointments in four primary care clinics (over 25 healthcare providers [HCPs]). These measurements were performed before (baseline, n = 51) and 1 month after implementing the 5As of Obesity Management (post-intervention, n = 51). Intervention consisted of one online training session (90 min) and distribution of the 5As toolkit to HCPs of participating clinics. Subjects completing the survey before and after the intervention were comparable in terms of age, sex, body mass index, comorbidities, satisfaction and self-reported health status (P > 0.2). Implementing the 5As of Obesity Management resulted in a twofold increase in the initiation of obesity management (19 vs. 39%, P = 0.03), and caused a statistically significant increase in the perceived follow-up/coordination efforts (self-reported Patient Assessment of Chronic Illness Care components, 45 +/- 22 vs. 67 +/- 12 points, P = 0.002), as well as two components of the 5As framework: Assess (50 +/- 29 vs. 66 +/- 15 points, P = 0.03) and Assist (54 +/- 26 vs. 72 +/- 13 points, P = 0.01). Our results suggest that using the 5As of Obesity Management facilitates weight management in primary care by promoting physician-patient communications, medical assessments for obesity and plans for follow-up care.