Banerjee, Elaine, MD, MPH

Shaak, Kyle, MPH

Veseli, Elton

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksResearch Scholars Poster PresentationDeterminants of Treatment For ObesityElton VeseliElton.Veseli@lvhn.orgElaine Banerjee MD, MPHLehigh Valley Health Network, Elaine_S.Banerjee@lvhn.orgKyle Shaak MPHLehigh Valley Health Network, Kyle.Shaak@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars-postersThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtVeseli, E. Banerjee, E. Shaak, K. (2019, August). Determinants of Treatment For Obesity. Poster Presented at: LVHN Research ScholarProgram Poster Session, Lehigh Valley Health Network, Allentown, PA.Lehigh	Valley	Health	Network,	Allentown,	Pennsylvania• The	negative	physical,	social,	and	psychological	effects	of	having	obesity	demand	that	its	underdiagnosis be	addressed.• As	of	2014,	37.9% of	the	adult	population	had	a	Body	Mass	Index	(BMI)	≥30kg/m2• A	cross-sectional	study	found:– 48% of	patients	with	BMI	≥	30	kg/m2 had	electronic	documentation	of	obesity.1• A large	study	of	patients	with	obesity	found:	– 17.6% received	weight	reduction	counseling– 25.2%	received	diet	counseling– 20.5% received	exercise	counseling.2• The	initial	assessment	of	a	randomized	controlled	trial	focused	on	the	effect	of	obesity	on	the	problem	list	found:– 36.2% of	obese	patients	had	obesity	on	the	problem	list	– 5.1%	of	obese	patients	with	obesity	not	on	the	problem	list	had	obesity	addressed	by	a	physician.3• Through	retrospective	chart	review,	a	database	of	96,019	patients	with	a	BMI≥	30kg/m2 was	established.	The	following	data	was	collected	from	each	patient:To	identify	the	patient	factors	that	are	associated	with	an	obesity	diagnosis.	BackgroundPrimary	ObjectiveMethods Notable	ResultsOutcomesDeterminants	of	Treatment	For	ObesityElton	Veseli,	Elaine	Banerjee	MD,	MPH,	Kyle	Shaak MPHDepartment	of	Family	MedicineSecondary	ObjectivesTo	identify	the	lab	orders	associated	with	an	obesity	diagnosis.To	identify	patient	factors,	obesity	diagnosis	code	usage,	and	obesity	related	lab	orders	associated	with	weight	loss.• According	to	the	Chi-squared	analysis,	the	following	patient	characteristics	are associated	with	the	use	of	an	obesity	diagnosis	code:1. Race	and	Ethnicity2. Sex3. Primary	Language4. Smoking	Status5. All	specified	comorbidities	except impaired	glucose	tolerance• Women	are	more likely	to	receive	an	obesity	diagnosis	than	men.• HA1c	for	diagnosis	group	was	slightly	lower than	HA1c	for	non-diagnosis	group.	This	is	likely	due	to	a	higher	testing	rate for	diagnosis	group	relative	to	the	non-diagnosis	group.• Total	cholesterol	for	diagnosis	group	was	slightly	lower than	total	cholesterol	for	non-diagnosis	group	despite similar	testing	rates	between	the	groups.• Inclusion of	obesity	on	problem	list	is	a	significant	marker	for	obesity	diagnosis.	However,	14.6% of	patients	with	obesity	on	the	problem	list	do	not	have	an	obesity	diagnosis.	• Internal	medicine	is	responsible	for	more	obesity	diagnoses	than	family	medicine.	• 0.42% of	the	total	patient	pool	received	a	nutrition	referral.	• Those	with	an	obesity	diagnosis	saw	a	decrease in	BMI,	whereas	those	without	an	obesity	diagnosis	saw	an	increase in	BMI.• 55.7% of	those	who	have	Spanish as	a	primary	language	were	diagnosed	as	obese	compared	to	45.2% of	those	who	have	Englishas	a	primary	language.• In	the	future,	one	might	look	at	the	relationship	between	a	physician’s	BMI	and	their	diagnosis	of	obesity	in	patients.• There	is	opportunity	for	improvement	to	decrease	the	number	of	patients	who	have	obesity	on	the	problem	list	without	an	obesity	diagnosis.• There	is	also	opportunity	for	improvement	to	increase	the	percentage	of	patients	that	have	obesity	on	the	problem	list	given	that	studies	show	that	it	is	more	likely	to	be	addressed.3References1. Pantalone KM, et al. Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system. BMJ Open. 2017;7(11):e017583. 2. Bleich SN, Pickett-Blakely O, Cooper LA. Physician practice patterns of obesity diagnosis and weight-related counseling. Patient EducCouns. 2011;82(1):123-129.3. Seaton Banerjee, Elaine & Gambler, Angela & Fogleman, Corey. (2013). Adding Obesity to the Problem List Increases the Rate of Providers Addressing Obesity. Family medicine. 45. 629-33.

Determinants of Treatment For Obesity

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Determinants of Treatment For Obesity

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