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. 2024 Jan-Dec:15:21501319241308054.
doi: 10.1177/21501319241308054.

An Evaluation of Primary Care Clinician Referrals for Behavioral Weight Loss Counseling

Veeral M Saraiya  1 , Seth A Berkowitz  1 , Larry F Johnston  1 , David J Couper  1 , Daniela Sotres-Alvarez  1 , Kiira M Lyons  1 , Cheyenne K Thaxton  1 , Harlyn G Skinner  1 , Carmen D Samuel-Hodge  1 , Thomas C Keyserling  1
Affiliations

An Evaluation of Primary Care Clinician Referrals for Behavioral Weight Loss Counseling

Veeral M Saraiya et al. J Prim Care Community Health. 2024 Jan-Dec.

Abstract

Introduction/objectives: In the context of enrolling patients from primary care practices into a weight loss research study, this study describes the percentage of patients primary care clinicians (PCCs) considered appropriate for referral and study participation rates among those referred.

Methods: An electronic health record review identified 5322 patients aged 18 to 75 years with BMI ≥ 30 kg/m2 as eligible for review by community, attending, and resident PCCs for referral to a weight loss study. Referrals and patient interest in participating in the study are reported overall and by PCC type.

Results: The mean (SD) age was 53.1 (13.9) years, mean BMI 36.5 (6.2) kg/m2, 41.5% were male, and 30.9% were African American. PCCs reviewed 3882 patients and referred 2762 (71.1%) to the study. Of 1120 not referred, 260 (23.2%) were not known well enough by PCCs to assess for referral. The most common reasons for not referring included too much comorbidity (171, 15.3%), psychological reasons (170, 15.2%), and non-English speaking (125, 11.2%). Among 1897 patients invited to participate, 676 (35.6%) expressed interest and 360 (19.0%) were enrolled.

Conclusions: PCCs referred 71.1% of their eligible patients. Among those referred, interest in participation was modest and enrollment was low.

Trial registration: ClinicalTrials.gov Identifier: NCT04302727.

Keywords: Mediterranean diet; intensive behavioral weight management; obesity; primary care; randomized clinical trial.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Berkowitz reports research grants from NIH/NHLBI, Blue Cross Blue Shield of North Carolina, North Carolina Department of Health and Human Services, American Diabetes Association, Rockefeller Foundation, and the American Heart Association outside of the submitted work. He reports consulting fees from Kaiser Permanente outside of the submitted work. Dr. Couper reports research grants from NIH/NHLBI, NIH/NIDDK, and the COPD Foundation outside of the submitted work. Dr. Sotres-Alvarez reports research grants from NIH/NHLBI, NIH/NIDDK, and NIH/NIMHD outside of the submitted work. Dr. Samuel Hodge reports research grants from NIH/NIMHD and CDC outside of the submitted work. Dr. Keyserling reports research grants from NIH/NIDDK, NIH/OD/NICHD, CDC, and the Duke Endowment outside of the submitted work. Dr. Keyserling’s wife was founder and now volunteer advisor to a company that makes healthful frozen foods. She does not hold equity in the company.

Figures

Figure 1.
Figure 1.
Flow of participants through screening.
Figure 2.
Figure 2.
Composition of patients by enrollment stage. This Figure displays the percentage of the study sample composed of subgroups of interest at each enrollment time point. Panel A displays the composition of male patients over the course of enrollment. Panel B displays the composition of African American patients over the course of enrollment. Panel C displays the composition of Persons with diabetes over the course of enrollment. Note that Stage 3, “Invited to participate,” represents the sample enriched with subgroups of interest (males, African Americans, and those with diabetes). The frequency counts for these subgroups are available in eTable 1.”
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