Abstracts / Posters
How are general practitioners (GPs) and practice nurses (PNs) currently managing obese patients?
Accepted for poster presentation, Diabetes UK 2003
The Counterweight Project Team
Introduction: Promoting lifestyle change with improvement in diet and physical activity levels is crucial for diabetes control and prevention. However, little is known about how GPs and PNs currently manage obesity.
Methods: Medical records were reviewed for 100 randomly selected obese patients (BMI> 30) from 40 UK practices (n=4000) in 7-centre Counterweight programme. Data were collected on Practice-based diet counselling, dietetic or obesity centre referrals, and anti-obesity medication.
Results: Recorded over 18 months were practice-based diet counselling (20%), dietetic (4%) and obesity centre (1%) referrals, and any anti-obesity medication (2%). Major obesity-related co-morbidities (diabetes, dyslipidaemia, hypertension, coronary heart disease) were independent Multi-variate predictors of counselling (P<0.001) and dietetic referral (P<0.001) as was higher BMI (P<0.05 for counselling, P<0.001dietetic referral). Patients referred to obesity centres were younger (42.3:49.6yr; P<0.01) and more obese (BMI 39.8:34.4; P<0.01) than those not referred. Patients prescribed anti-obesity medication were more likely to be female (P<0.01), younger (P=0.07) and more obese (P<0.01) but with similar co-morbidity prevalence (P=0.98) than those not prescribed.
Conclusion: Practice-based counselling is the most common intervention. Obesity severity and co-morbidities predict practice-based diet counselling and dietetic referral. However co-morbidity prevalence did not influence referrals to obesity centres or the prescribing of anti-obesity medication.