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A Cross-Sectional Study Examining Australian General Practitioners’ Identification of Overweight and Obese Patients

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A Commentary to this article was published on 23 October 2013

ABSTRACT

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.

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Acknowledgements

Funding

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).

Contributors

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.

Prior Presentations

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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Authors and Affiliations

  1. Priority Research Centre for Health Behaviour and Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW, 2308, Australia

    Sze Lin Yoong B. NutrDiet (Hons), Mariko Leanne Carey PhD, Robert William Sanson-Fisher PhD, Catherine Anne D’Este PhD, Lisa Mackenzie B Psych (Hons) & Allison Boyes PhD

  2. Centre for Clinical Epidemiology and Biostatistics and Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW, 2308, Australia

    Catherine Anne D’Este PhD

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  1. Sze Lin Yoong B. NutrDiet (Hons)
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Correspondence to Sze Lin Yoong B. NutrDiet (Hons).

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Yoong, S.L., Carey, M.L., Sanson-Fisher, R.W. et al. A Cross-Sectional Study Examining Australian General Practitioners’ Identification of Overweight and Obese Patients. J GEN INTERN MED 29, 328–334 (2014). https://doi.org/10.1007/s11606-013-2637-4

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  • DOI: https://doi.org/10.1007/s11606-013-2637-4

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