Abstract
BackgroundPrimary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI).MethodsWe performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity.ResultsSurveys were distributed to 591 PCPs (n = 538 family physicians; n = 53 nurse practitioners) identified as practicing in the Southeastern Ontario and 92 (15.6%) participated. PCPs serving a rural population estimated that 14.2 ± 10.9% of patients would qualify for MSWLI compared to 9.9 ± 8.5% of patients of PCPs serving an urban population (p = .049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past 5 years.ConclusionThe majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.
Highlights
Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI)
Primary Care Providers (PCPs) are well-positioned to direct timely treatment and management of obesity in their patients as they are the primary contact for patients seeking medical and surgical weight loss interventions (MSWLI)
Surveys were distributed to 591 PCPs (n = 538 family physicians; n = 53 nurse practitioners)
Summary
Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI). Primary Care Providers (PCPs) are well-positioned to direct timely treatment and management of obesity in their patients as they are the primary contact for patients seeking medical and surgical weight loss interventions (MSWLI). Bariatric surgery (BS) is the only intervention that results in significant and sustained weight-loss, improvement and/or resolution of obesity-related comorbidities in patients with class II and III obesity (Body Mass Index (BMI) 35.0–39.9 kg/m2 and BMI ≥ 40.0 kg/ m2, respectively) [1, 4,5,6,7,8,9,10]; PCPs continue to prescribe lifestyle modification as the recommended treatment for these patients [11]. Millions of Canadians continue to struggle with the obesity-related co-morbidities and social issues associated with obesity
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