An Evaluation of Primary Care Clinician Referrals for Behavioral Weight Loss Counseling.

Abstract

Introduction/objectives: In the context of enrolling patients from primary care practices into a weight loss research study, this study describes the percentage of patients primary care clinicians (PCCs) considered appropriate for referral and study participation rates among those referred.

Methods: An electronic health record review identified 5322 patients aged 18 to 75 years with BMI ≥ 30 kg/m² as eligible for review by community, attending, and resident PCCs for referral to a weight loss study. Referrals and patient interest in participating in the study are reported overall and by PCC type.

Results: The mean (SD) age was 53.1 (13.9) years, mean BMI 36.5 (6.2) kg/m², 41.5% were male, and 30.9% were African American. PCCs reviewed 3882 patients and referred 2762 (71.1%) to the study. Of 1120 not referred, 260 (23.2%) were not known well enough by PCCs to assess for referral. The most common reasons for not referring included too much comorbidity (171, 15.3%), psychological reasons (170, 15.2%), and non-English speaking (125, 11.2%). Among 1897 patients invited to participate, 676 (35.6%) expressed interest and 360 (19.0%) were enrolled.

Conclusions: PCCs referred 71.1% of their eligible patients. Among those referred, interest in participation was modest and enrollment was low.

Trial registration: ClinicalTrials.gov Identifier: NCT04302727.