Prelude to PATHWEIGH: pragmatic weight management in primary care.

Prelude to PATHWEIGH: pragmatic weight management in primary care.
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PATHWEIGH 的前奏:初级保健中的务实体重管理。

DOI:
10.1093/fampra/cmac092
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发表时间:
2023
期刊:
影响因子:
2.2
通讯作者:
Perreault,Leigh
Perreault,Leigh
中科院分区:
医学4区
文献类型:
--
作者:
Wild,Jessica;Kaizer,Alexander;Willems,Emileigh;Kramer,ErikSeth;Perreault,Leigh

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目的治疗肥胖相关疾病,而不是肥胖本身,仍然是医疗保健的支柱。当前的研究探讨了一种在初级保健中优先考虑体重管理的新方法,以改变这种范式。方法 PATHWEIGH 是一种体重管理方法,包括员工团队培训、工作流程系统管理和电子病历 (EPIC) 内置工具的数据采集。使用同一美国医疗保健系统中的两个家庭医学诊所将 PATHWEIGH 与护理标准 (SOC) 进行比较。描述性统计数据比较了至少进行过一次体重优先就诊 (WPV) 和 14 个月内一次体重随访的患者、提供者和诊所层面的因素。 结果 就患者总就诊次数(7,353 例与 7,984 例)以及符合 WPV 资格的患者(即 >18 岁 + 体重指数 >25 kg/m2;3,746 例与 3,746 例)而言,各组相似。 3,008,分别是 PATHWEIGH 与 SOC)。然而,更多的 PATHWEIGH 诊所患者(15.9% vs. 8.4%;P<0.001)接受了至少一种 WPV。尽管 14 个月内患者平均体重减轻没有观察到差异 (P= 0.991),但 PATHWEIGH 中每位患者的 WPV 数量较高 (P< 0.001),并且与体重减轻显着相关 (P= 0.001),每次额外就诊平均体重减轻 0.55 kg。 结论 当前研究的结果表明,从治疗与体重相关的合并症到治疗原发性体重的范式的早期成功转变 关心。
ObjectiveTreatment of obesity-related diseases, rather than obesity itself, remains the mainstay of medical care. The current study examined a novel approach that prioritizes weight management in primary care to shift this paradigm.MethodsPATHWEIGH is a weight management approach consisting of staff team training, workflow system management, and data capture from tools built into the electronic medical record (EPIC). PATHWEIGH was compared to standard of care (SOC) using two family medicine clinics in the same US healthcare system. Descriptive statistics compared patient-, provider-, and clinic-level factors between the groups among those with at least one weight-prioritized visit (WPV) and one follow-up weight over 14 months.ResultsGroups were similar in terms of total patient visits (7,353 vs. 7,984) and patients eligible for a WPV (i.e. >18 years + body mass index >25 kg/m2; 3,746 vs. 3,008, PATHWEIGH vs. SOC, respectively). However, more PATHWEIGH clinic patients (15.9% vs. 8.4%;P< 0.001) received at least one WPV. Although no difference was observed for average patient weight loss over 14 months (P= 0.991), the number of WPVs per patient was higher in PATHWEIGH (P< 0.001) and significantly associated with weight loss (P= 0.001), with an average decrease in weight of 0.55 kg per additional visit.ConclusionsResults from the current study demonstrate early success in changing the paradigm from treating weight-related comorbidities to treating weight in primary care.
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