Patient characteristics related to intensity of weight reduction care in a university medical clinic

Objective:To identify patient characteristics related to intensity of weight reduction care provided in a primary care practice. Design:Cross-sectional study linking data from a patient survey and data from medical records. Setting:Internal medicine housestaff clinic in an urban university hospital. Participants:321 outpatients who represented a systematic sample of all outpatients who had visited the clinic over one year. Measurements and main results:The patient population was largely black (86%) and female (65%). Most patients (54%) were overweight [body-mass index (BMI)>85th percentile for the United States by gender]. Intensity of care was defined by a composite scale: points were awarded for actions documented in the medical chart or recalled by the patient. Factors independently associated with a higher intensity of care among the 161 overweight patients were: BMI [odds ratio (OR)=1.13 per kg/m ²;95% confidence interval (95% CI)=1.04, 122; p=0.002], the patient's self-perception of being overweight (OR=5.37; 95% CI=1.99, 14.46; p=0.001), and age of 64 years or younger (OR=2.48; 95% CI=1.12, 5.48; p=0.02). Race, gender, and presence of hypertension or hypercholesterolemia were not associated with greater intensity of care. Conclusions:Patients with hypertension and hypercholes-terolemia may be receiving suboptimal weight reduction care. Heightened awareness of being overweight may enbance the provision of weight reduction care. Prospective studies are required to confirm these findings.