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- Title
A Primary Care–Based Weight Navigation Program.
- Authors
Griauzde, Dina H.; Turner, Cassie D.; Othman, Amal; Oshman, Lauren; Gabison, Jonathan; Arizaca-Dileo, Patricia K.; Walford, Eric; Henderson, James; Beckius, Deena; Lee, Joyce M.; Carter, Eli W.; Dallas, Chris; Herrera-Theut, Kathyrn; Richardson, Caroline R.; Kullgren, Jeffrey T.; Piatt, Gretchen; Heisler, Michele; Kraftson, Andrew
- Abstract
Key Points: Question: Can a primary care–based weight navigation program (WNP) support weight loss among patients with obesity through weight-focused consultation visits with obesity medicine experts and preference-sensitive use of weight management treatments? Findings: In this cohort study including 264 patients, WNP patients (n = 132), compared with matched controls (n = 132) were referred at higher rates to health system weight management treatments. In addition, patients in the WNP lost significantly more weight (−4.4% vs −0.1%) and had greater odds of achieving 5% or more and 10% or more weight loss compared with controls. Meaning: The findings of this study suggest that the WNP model offers a promising approach to improve treatment and outcomes for patients with obesity and warrants further evaluation in a large-scale clinical trial. Importance: Evidence-based weight management treatments (WMTs) are underused; strategies are needed to increase WMT use and patients' weight loss. Objective: To evaluate the association of a primary care–based weight navigation program (WNP) with WMT use and weight loss. Design, Setting, and Participants: This cohort study comprised a retrospective evaluation of a quality improvement program conducted from October 1, 2020, to September 30, 2021. Data analysis was performed from August 2, 2022, to March 7, 2024. Adults with obesity and 1 or more weight-related condition from intervention and control sites in a large academic health system in the Midwestern US were propensity matched on sociodemographic and clinical factors. Exposure: WNP, in which American Board of Obesity Medicine–certified primary care physicians offered weight-focused visits and guided patients' selection of preference-sensitive WMTs. Main Outcomes and Measures: Primary outcomes were feasibility measures, including rates of referral to and engagement in the WNP. Secondary outcomes were mean weight loss, percentage of patients achieving 5% or more and 10% or more weight loss, referral to WMTs, and number of antiobesity medication prescriptions at 12 months. Results: Of 264 patients, 181 (68.6%) were female and mean (SD) age was 49.5 (13.0) years; there were no significant differences in demographic characteristics between WNP patients (n = 132) and matched controls (n = 132). Of 1159 WNP-eligible patients, 219 (18.9%) were referred to the WNP and 132 (11.4%) completed a visit. In a difference-in-differences analysis, WNP patients lost 4.9 kg more than matched controls (95% CI, 2.11-7.76; P <.001), had 4.4% greater weight loss (95% CI, 2.2%-6.4%; P <.001), and were more likely to achieve 5% or more weight loss (odds ratio [OR], 2.90; 95% CI, 1.54-5.58); average marginal effects, 21.2%; 95% CI, 8.8%-33.6%) and 10% or more weight loss (OR, 7.19; 95% CI, 2.55-25.9; average marginal effects, 17.4%; 95% CI, 8.7%-26.2%). Patients in the WNP group were referred at higher rates to WMTs, including bariatric surgery (18.9% vs 9.1%; P =.02), a low-calorie meal replacement program (16.7% vs 3.8%; P <.001), and a Mediterranean-style diet and activity program (10.6% vs 1.5%; P =.002). There were no between-group differences in antiobesity medication prescribing. Conclusions and Relevance: The findings of this cohort study suggest that WNP is feasible and associated with greater WMT use and weight loss than matched controls. The WNP warrants evaluation in a large-scale trial. This cohort study examines the use of a weight navigation program comprising primary care physicians offering weight-focused visits and guidance on patients' selection of treatment.
- Subjects
WEIGHT loss; BARIATRIC surgery; HUMAN services programs; MEDITERRANEAN diet; BODY mass index; RESEARCH funding; PRIMARY health care; REGULATION of body weight; STRATEGIC planning; RETROSPECTIVE studies; DESCRIPTIVE statistics; PATIENT-centered care; LONGITUDINAL method; ODDS ratio; ANTIOBESITY agents; QUALITY assurance; SOCIODEMOGRAPHIC factors; CONFIDENCE intervals
- Publication
JAMA Network Open, 2024, Vol 7, Issue 5, pe2412192
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.12192