A Cross-Sectional Study Examining Australian General Practitioners’ Identification of Overweight and Obese Patients
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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.
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.
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.
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.
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.
KEY WORDSoverweight obesity general practice family physician validity add detection risk factor assessment
This work was funded by a research grant from the National Heart Foundation and beyondblue (G0189464), and Cancer Institute of New South Wales (08/RFG/1-20).
All listed authors made substantive contributions to the design, conduct or reporting of this study. There are no other individuals who made substantial contributions but do not meet criteria for authorship.
Oral presentation at the 10th Australasian Society of Behavioural Medicine, Newcastle, Australia 6–8 February 2013, and the Heart Foundation Conference, Adelaide, Australia, 16–18 May 2013.
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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