Patient factors have greatest influence on weight clinic attendance
medwireNews: Patient-level characteristics such as age, BMI, and deprivation level have a greater influence on an individual’s likelihood of attending a specialist weight management service (WMS) than do practice-level characteristics, UK study data show.
And the researchers note that there “was wide variation in referral rates across general practice, suggesting that there is still much to do to improve engagement with weight management by primary care practitioners.”
Between 2012 and 2014, 262 general practices in the West of Scotland referred 9677 adults with obesity (BMI ≥30 kg/m2) to a regional specialist WMS. Practice referral rates ranged from 1 to 257 patients.
Of the patients referred, only 3250 (33.6%) attended at least one session and 2252 (23% overall, 69% of attendees) completed the intervention by attending four or more sessions.
“The high attrition rate from referral to attendance and from attendance to completion suggests ongoing barriers for patients,” say Catherine O'Donnell and colleagues from the University of Glasgow.
Indeed, O’Donnell and team found that patient-level characteristics such as age, BMI, and affluence were the strongest predictors of attendance.
Specifically, patients aged 65 years and older were a significant 4.15 times more likely to attend the WMS than those aged 18–24 years, patients with a BMI of 45 kg/m2 or higher were 1.83 times more likely to attend than those with a BMI of 30–35 kg/m2, and the most affluent patients (Scottish Index of Multiple Deprivation [SIMD] 2012 quintile 5) were 1.74 times more likely to attend than the most deprived (SIMD 2012 quintile 1).
In addition, men were significantly less likely than women to attend, at an odds ratio (OR) of 0.87.
Practice-level characteristics also impacted WMS attendance, but to a lesser degree. Patients referred from training practices were significantly less likely to attend than those referred from non-training practices (OR=0.89), while patients from larger practices (list size 4000–8000 and >8000) were more likely to attend than those from smaller practices (OR=1.41 and 1.29, respectively).
Finally, patients attending practices where more than 40% of the population live in the most deprived postcodes were significantly less likely to attend the WMS than those living in less deprived areas (OR=0.82).
By contrast, practice characteristics of quality and distance from the nearest WMS were not significantly associated with attendance, and the researchers note that similar patterns were observed for patients who completed the sessions at the WMS.
Writing in BMJ Open, O’Donnell and co-authors conclude: “Patient and practice-level characteristics can help us understand the observed variation in attendance at specialist WMS following general practitioner (GP) referral and the underlying explanations for these differences merit further investigation.”
By Laura Cowen
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