FRI081 Quality Improvement Initiative To Improve Management Of Obesity In A Primary Care Resident Continuity Clinic

Abstract

Abstract Disclosure: M.G. Fernandez: None. M. Hillhouse: None. D. Ozimek: None. M. Salvo: None. Background: Obesity is a leading health concern in the US and a growing epidemic worldwide. Despite the substantial evidence on weight management interventions, it remains the least commonly addressed medical problem. Physicians also document obesity infrequently in medical records. It has been well established that increasing documentation of obesity improves its management as a chronic disease. Objective: The main aim of our project was to increase the percentage of patients with a body mass index (BMI) ≥30kg/m2 with documented obesity in the electronic medical record (EMR) from 42% to 70%. The second aim was to increase the percentage of patients with a BMI ≥30kg/m2 prescribed weight loss pharmacotherapy from 10% to 40%. The project was performed in an Internal Medicine residency program continuity clinic over six months. Methods: We used three cycles of the Plan-Do- Study-Act methodology; all included education in obesity medicine, distribution of a hard copy list of the patients who met inclusion criteria, and EMR message reminders to address obesity by the following medical appointment. The EMR was used to generate reports to track outcomes. The first report listed all the resident clinic patients with a documented BMI ≥30kg/m2. The following list the number of patients with BMI ≥30kg/m2 and a corresponding diagnosis of obesity in their chart. The last report listed the number of patients with BMI ≥30kg/m2 on weight loss pharmacotherapy. Reports were generated bi-monthly, and percentages were used to determine the efficacy of each cycle. Results: There were 25% of residents’ patients who met project inclusion criteria. Of this, 11% were prescribed pharmacotherapy at baseline. Of those receiving treatment, 98% had type 2 diabetes. After the interventions, the documentation of obesity in the EMR increased from 42% to 60%. As a result, the overall number of patients on weight loss pharmacotherapy increased from 10.53% to 12.68%. Conclusion: The overall goal of the interventions was successful. There was an increase in both EMR documentation of obesity and increased weight loss pharmacotherapy prescribing; however, both were lower than anticipated. It was also found that the resident physicians responded more to printed metrics of their population of patients. In addition, physicians were more susceptible to treating patients when obesity was documented as a chronic disease. However, this project emphasizes that more efforts should be made to engage residents in multidisciplinary training to improve the management of obesity and increase tools to navigate through barriers to obesity treatments. Presentation: Friday, June 16, 2023