Impact of Physician Training on Diagnosis and Counseling of Overweight and Obese Asian Patients.

Abstract

Obesity is widely underdiagnosed among Asians, due in part to a lack of physician awareness of the modified diagnostic criteria for Asians. This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients. Physicians (N=16) from five primary care practices received 1h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12months before the training (n=198) and 3months following the training (n=163). Physician race (Asian/non-Asian) and clinic setting (private/academic) were included as outcome moderators. Patients were predominantly male (63.1%), with a mean age of 46.0years (SD=14.9) and an average BMI of 28.2 (SD=3.8). Across all physicians, 26.8 and 45.1% of patients were accurately diagnosed as overweight or obese before and after the training, respectively (p<0.05). The odds of a physician correctly diagnosing Asian patients as overweight or obese were 102% higher at post-training after accounting for nesting of patients within physicians. Similarly, weight counseling was higher (65.0%) following training compared to pre-training levels (43.9%) but failed to reach significance (p=0.06). Accurate identification and counseling of overweight/obese Asian patients can be improved by education and training. Universal adoption of race-specific guidelines will ensure more successful weight management and reduced morbidity in a rapidly growing Asian population.