BACKGROUND: Overweight and obese patients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such advice. One reason may be that physicians do not identify their overweight and obese patients. OBJECTIVES: We aimed to determine the extent that Australian general practitioners (GP) recognise overweight or obesity in their patients, and to explore patient and GP characteristics associated with non-detection of overweight and obesity. METHODS: Consenting adult patients (n = 1,111) reported weight, height, demographics and health conditions using a touchscreen computer. GPs (n = 51) completed hard-copy questionnaires indicating whether their patients were overweight or obese. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GP detection, using patient self-reported weight and height as the criterion measure for overweight and obesity. For a subsample of patients (n = 107), we did a sensitivity analysis with patient-measured weight and height. We conducted an adjusted, multivariable logistic regression to explore characteristics associated with non-detection, using random effects to adjust for correlation within GPs. RESULTS: Sensitivity for GP assessment was 63 % [95 % CI 57-69 %], specificity 89 % [95 % CI 85-92 %], PPV 87 % [95 % CI 83-90 %] and NPV 69 % [95 % CI 65-72 %]. Sensitivity increased by 3 % and specificity was unchanged in the sensitivity analysis. Men (OR: 1.7 [95 % CI 1.1-2.7]), patients without high blood pressure (OR: 1.8 [95 % CI 1.2-2.8]) and without type 2 diabetes (OR: 2.4 [95 % CI 1.2-8.0]) had higher odds of non-detection. Individuals with obesity (OR: 0.1 [95 % CI 0.07-0.2]) or diploma-level education (OR: 0.3 [95%CI 0.1-0.6]) had lower odds of not being identified. No GP characteristics were associated with non-detection of overweight or obesity. CONCLUSIONS: GPs missed identifying a substantial proportion of overweight and obese patients. Strategies to support GPs in identifying their overweight or obese patients need to be implemented.
BACKGROUND: Overweight and obesepatients attempt weight loss when advised to do so by their physicians; however, only a small proportion of these patients report receiving such advice. One reason may be that physicians do not identify their overweight and obesepatients. OBJECTIVES: We aimed to determine the extent that Australian general practitioners (GP) recognise overweight or obesity in their patients, and to explore patient and GP characteristics associated with non-detection of overweight and obesity. METHODS: Consenting adult patients (n = 1,111) reported weight, height, demographics and health conditions using a touchscreen computer. GPs (n = 51) completed hard-copy questionnaires indicating whether their patients were overweight or obese. We calculated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for GP detection, using patient self-reported weight and height as the criterion measure for overweight and obesity. For a subsample of patients (n = 107), we did a sensitivity analysis with patient-measured weight and height. We conducted an adjusted, multivariable logistic regression to explore characteristics associated with non-detection, using random effects to adjust for correlation within GPs. RESULTS: Sensitivity for GP assessment was 63 % [95 % CI 57-69 %], specificity 89 % [95 % CI 85-92 %], PPV 87 % [95 % CI 83-90 %] and NPV 69 % [95 % CI 65-72 %]. Sensitivity increased by 3 % and specificity was unchanged in the sensitivity analysis. Men (OR: 1.7 [95 % CI 1.1-2.7]), patients without high blood pressure (OR: 1.8 [95 % CI 1.2-2.8]) and without type 2 diabetes (OR: 2.4 [95 % CI 1.2-8.0]) had higher odds of non-detection. Individuals with obesity (OR: 0.1 [95 % CI 0.07-0.2]) or diploma-level education (OR: 0.3 [95%CI 0.1-0.6]) had lower odds of not being identified. No GP characteristics were associated with non-detection of overweight or obesity. CONCLUSIONS: GPs missed identifying a substantial proportion of overweight and obesepatients. Strategies to support GPs in identifying their overweight or obesepatients need to be implemented.
Authors: Adrian J Cameron; David W Dunstan; Neville Owen; Paul Z Zimmet; Elizabeth L M Barr; Andrew M Tonkin; Dianna J Magliano; Shirley G Murray; Timothy A Welborn; Jonathan E Shaw Journal: Med J Aust Date: 2009-08-17 Impact factor: 7.738
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