1101-P: Patient-Centered Weight Management Clinical Decision Support—A Proof-of-Concept Study

Introduction & Objective: Over 40% of U.S. adults have obesity; however, primary care practitioners (PCPs) face challenges treating obesity (e.g., lack of training, time). Clinical decision support (CDS) tools can aid obesity counseling, but most lack a patient-centered care focus. The study objective was to develop and test an innovative weight management CDS for the primary care setting.

Methods: The CDS design promoted a patient-centered experience, supported evidence-based obesity treatment, and integrated with PCPs’ workflows in the electronic health record. Patients completed a pre-visit questionnaire via the patient portal, which then activated PCP elements (decision/counseling, orders, documentation). A 3-month proof-of-concept study was conducted among 10 PCPs at 5 clinics to determine usefulness, usability, and acceptability through validated surveys (mean score ≥2.5 signified positive outcome; max value 5). Using t-tests, pre-post differences in frequency of self-reported obesity-related clinical practices (Never-1 to Always-5) were also examined.

Results: Most PCPs were physicians with mean 10.8 years (SD 7.5) of primary care experience. Overall, mean score for usefulness, usability, and acceptability was 3.2 (SD 0.8), 3.5 (SD 0.9), and 3.6 (SD 0.9), respectively. PCPs highly rated recommending the CDS to a colleague (mean 3.9 (SD 1.0)), found the CDS easy-to-use (mean 3.7 (SD 0.9)), and suitable for the primary care setting (mean 4.1 (SD 1.0)). PCPs reported significant increases in three key clinical practices - counseling on behavioral interventions (3.1 vs 3.9 (p<0.01)), referring to weight-loss programs (2.8 vs 3.5 (p<0.01)), and discussing anti-obesity medications (3.3 vs 3.8 (p=0.02)).

Conclusion: A patient-centered weight management CDS was useful and usable to PCPs and improved obesity-related practice habits. Future studies need to evaluate CDS use in other outpatient settings and its impact on patient outcomes.