Patient and practice characteristics predicting attendance and completion at a specialist weight management service in the UK: a cross-sectional study

Blane, D. N. , McLoone, P., Morrison, D., Macdonald, S. and O'Donnell, C. A. (2017) Patient and practice characteristics predicting attendance and completion at a specialist weight management service in the UK: a cross-sectional study. BMJ Open, 7(11), e018286. (doi:10.1136/bmjopen-2017-018286) (PMID:29162575) (PMCID:PMC5719278)

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Abstract

Objective: To determine the association between patient and referring practice characteristics and attendance and completion at a specialist health service weight management service (WMS). Design: Cross-sectional study. Setting: Regional specialist WMS located in the West of Scotland. Participants: 9677 adults with obesity referred between 2012 and 2014; 3250 attending service and 2252 completing. Primary and secondary outcome measures: Primary outcome measure was attendance at the WMS; secondary outcome was completion, defined as attending four or more sessions. Analysis: Multilevel binary logistic regression models constructed to determine the association between patient and practice characteristics and attendance and completion. Results: Approximately one-third of the 9677 obese adults referred attended at least one session (n=3250, 33.6%); only 2252 (23%) completed by attending four or more sessions. Practice referrals ranged from 1 to 257. Patient-level characteristics were strongest predictors of attendance; odds of attendance increased with age (OR 4.14, 95% CI 3.27 to 5.26 for adults aged 65+ compared with those aged 18–24), body mass index (BMI) category (OR 1.83, 95% CI 1.56 to 2.15 for BMI 45+ compared with BMI 30–35) and increasing affluence (OR 1.96, 95% CI 1.17 to 3.28). Practice-level characteristics most strongly associated with attendance were being a non-training practice, having a larger list size and not being located in the most deprived areas. Conclusions: There was wide variation in referral rates across general practice, suggesting that there is still much to do to improve engagement with weight management by primary care practitioners. The high attrition rate from referral to attendance and from attendance to completion suggests ongoing barriers for patients, particularly those from the most socioeconomically deprived areas. Patient and practice-level characteristics can help us understand the observed variation in attendance at specialist WMS following general practitioner (GP) referral and the underlying explanations for these differences merit further investigation.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McLoone, Mr Philip and Morrison, Dr David and O'Donnell, Professor Catherine and Blane, Dr David and Macdonald, Dr Sara
Authors: Blane, D. N., McLoone, P., Morrison, D., Macdonald, S., and O'Donnell, C. A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:20 November 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BMJ Open 7(11): e018286
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
636631Understanding the role of primary care in the management of co-morbid obesity: a mixed methods programme.Catherine O'DonnellChief Scientist office (CSO)CAF/13/13IHW - GENERAL PRACTICE & PRIMARY CARE